Intranasal Ketamine Versus Intravenous Ketorolac for Pain Control in the Renal Colic: A Randomized Clinical Trial Study


Ali Khavanin 1 , Meisam Moezzi 1 , * , Hassan Motamed 1 , Samaneh Parozan 1 , Abdolreza Hosseini 1

1 Emergency Department, Jundishapur University of Medical Sciences, Ahvaz, Iran

How to Cite: Khavanin A, Moezzi M , Motamed H , Parozan S , Hosseini A . Intranasal Ketamine Versus Intravenous Ketorolac for Pain Control in the Renal Colic: A Randomized Clinical Trial Study, Jundishapur J Chronic Dis Care.2021 In Press(In Press): e114775. doi: 10.5812/jjcdc.114775.


Jundishapur Journal of Chronic Disease Care: In Press (In Press); e114775
Published Online: June 05, 2021
Article Type: Research Article
Received: March 22, 2021
Revised: April 20, 2021
Accepted: May 03, 2021


Background: Renal colic is one of the most common complaints referred to the emergency department (ED). Non-steroidal anti-inflammatory drugs (NSAIDs) and opioids are gold standards to relieve pain.

Objective: The aim of this study was to evaluate the effects of intranasal Ketamine on pain control versus Ketorolac.

Methods: In this randomized clinical trial, the patients were randomly divided into two groups. Ketorolac was given intravenously to all patients in the control group with 30 mg dosage, and in the intervention group, 1 mg/kg of drops of Ketamine was given intranasally. Pain severity, vital signs, and adverse events (AEs) were recorded after 60 min post-dose.

Results: 100 patients enrolled in this study. Results showed that the mean VAS score after the first 5 min was lower in the intranasal Ketamine group as compared to control (5 ± 2.26 vs. 8.62 ± 0.49, P<0.001, respectively), which remains significant at the end of 60th min (P<0.001). Moreover, additional analgesics administration was higher in intravenous Ketorolac than intranasal Ketamine (22 % vs 0), which was significantly different (P=0.001). Patients' satisfaction was higher in the intranasal Ketamine group (3.56 ± 0.35 vs. 1.82 ± 0.98, P<0.001).

Conclusions: Intranasal Ketamine in controlling renal colic-induced pain was beneficial, which could be prescribed as a treatment instead of normal treatment leads to improved pain relief in the short term and rapidly with lower AEs and increases the patients' satisfaction.


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