ACUTE RENAL COLIC

COMPARISON OF NELBUPHINE HYDROCHLORIDE WITH DICLOFENAC SODIUM DURING EMERGENCY MANAGEMENT

Abstract

Objective: To compare the efficacy of Nelbuphine hydrochloride (opioid) and Diclofenac Sodium (NSAID) in management of Acute
renal pain. Design: Prospective non-randomized quasi experimental study. Setting: This study was conducted in Emergency department (ED)
of Combined Military Hospital, Lahore. Period: From 1st April 2008 to 31 July 2009. Patients and Method: A Total of 100 patients presenting
in emergency department with a clinical diagnosis of renal and Ureteric colic were studied. They were randomly divided in to equal and
comparable groups, Group A & B. Severity of pain was assessed using a Visual Analogue scale (VAS). Group A was treated with Intravenous
Nelbuphine 10mg and group B was given intramuscular Diclofenac Sodium 75mg. Assessment of Pain relief, both onset and complete response
was assessed in both groups. In addition to the pain relief, side effects like Nausea, vomiting, respiratory depression, drowsiness and injection
site pain were also assessed. Results: Nelbuphine was found significantly superior (p=0.05) to Diclofenac, both for time of onset of pain relief
and complete pain relief. Moreover less patients required rescue analgesia in Group A (p=0.05). Only one patient treated with Group A had
respiratory depression which was statistically insignificant (p=0.05). There was a 3.5% increase in Nausea and vomiting in Nelbuphine treated
patients. Conclusion: Nelbuphine is a safe and rapid acting Opioid with few side effects. It should be preferred over Diclofenac sodium in
treatment of Acute Renal pain.