Ketoprofen versus Diclofenac sodium in the treatment of renal colic.

INTRODUCTION: Adult renal colic is a frequent lombo-abdominal painful syndrome in emergencies. Treatment is based on nonsteroidal anti-inflammatory drug (NSAID) but the choice between different NSAIDs remains a subject of controversy. Our aim was to compare the efficacy and the safety of two intramuscularly NSAIDs in renal colic. METHODS: We conducted a 32-week, randomized, double-blind, single-center study . Patients who had renal colic with a visual analogue scale (VAS) ≥ 5 were randomly assigned to receive, by intramuscularly injection, 100 mg of Ketoprofen (GK) or 75 mg of diclofenac (GD). If VAS > 3 after 40 minute, 1 g of paracetamol was administered as rescue analgesia. Primary endpoint was successful treatment. Secondary outcome was the occurrence of side effects. RESULTS: We have included 80 patients. the average age was 39 ± 13 years for GK versus 43 ± 14 years for GD. The mean VAS on admission was also similar in both arms. We objectified a therapeutic success rate of 92% in both groups. This success was similar in both arms. The use of rescue medication was 32.5% in the GK versus 47.5% in the GD (P=0.17). We have observed in 46% (n =37) of the study population side effects. These effects were only minor and no major intolerance expression was registered. CONCLUSION: the efficacy and tolerance of NSAIDs in the treatment of renal colic was the same for diclofenac and ketoprofen.

Inhaled nitrous oxide during the make stitches : Randomized double blind prospective study.

INTRODUCTION: Inhaled nitrous oxide (MEOPA) ensures short-term analgesia of a patient in spontaneous ventilation through a mask. It ensures analgesic coverage during the painful gesture while saving to the patient the phenomena of memorization. AIM: To study the efficacy and safety of the use of MEOPA during the make stitches. METHODS: Randomized double blind prospective study including any patient aged > 16 years admitted to the emergency for make stitches during a period of 3 months. After consent, patients were randomized to 2 groups (MEOPA versus placebo). When the stitches were made, if the patient has a VAS (visual analog scale) > 30%, an emergency analgesia with 2% subcutaneous xylocaine is performed. The primary endpoint was the degree of analgesia according to VAS. The secondary endpoints were the occurrence of side effects, patient and operator satisfaction. RESULTS: We collected 115 patients comparable in age, sex and pain at baseline. The mean of the VAS during suturing was 11.1±5.8% (MEOPA) versus 47.8±13.9% (placebo); and the mean at the end of the procedure was 5.2±5% (MEOPA) versus 27.6±12.8% (placebo) with p=0.000. Only minor adverse events (22% versus 16%) were observed with P = 0.306. CONCLUSION: We affirm the interest of this non-invasive, safe, innocuous analgesic technique that satisfies caregivers, patients and caregivers in suturing.