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International Urology and Nephrology
Published in: International Urology and Nephrology 3/2017

01-03-2017 | Urology - Original Paper

Treatment of reno-ureteral colic by twelfth intercostal nerve block with lidocaine versus intramuscular diclofenac

Authors: Miguel Maldonado-Avila, Marcos Del Rosario-Santiago, Jesus Emmanuel Rosas-Nava, Hugo Arturo Manzanilla-Garcia, Victor Manuel Rios-Davila, Patricia Rodriguez-Nava, Roberto Alejandro Vela-Mollinedo, Mateo Leopoldo Garduño-Arteaga

Published in: International Urology and Nephrology | Issue 3/2017

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Abstract

Introduction and objective

Renal colic is one of the most intense pains known to humans. Standard treatment usually consists of nonsteroidal anti-inflammatory drugs and opiates, but they do not always provide optimum efficacy and speed in relieving the pain. For more than 25 years, our hospital has been employing twelfth subcostal nerve block. The objective of the present study was to compare the efficacy of subcostal nerve block with lidocaine versus intramuscular diclofenac in renal colic management.

Methods

Sixty patients of both sexes, above the age of 18 years, and presenting with renal colic were randomly selected for the study. The visual analog scale was applied prior to the treatment and at minutes 1, 3, 5, 30, and 45 after the application of the twelfth nerve block or the intramuscular administration of diclofenac.

Results

A total of 60 patients, 35 women and 25 men, were included in the study. There were statistically significant differences in the mean scores for pain from minute 1 to minute 45. There were no adverse effects.

Conclusions

Twelfth Subcostal nerve block with lidocaine is an efficacious, safe, inexpensive, and very fast-acting medication for pain control related to renal colic. These characteristics make it superior to diclofenac.
Literature
1.
Esquena S, Millan Rodriguez F, Sanchez-Martin FM, Rousaud Baron F, Marchant F, Villavicencio Mavrich H (2006) Renal colic: revision of literature and scientific evidence. Actas Urol Esp 30(3):268–280CrossRefPubMed
2.
Leveridge M, D’Arcy FT, O’Kane D, Ischia JJ, Webb DR, Bolton DM et al (2016) Renal colic: current protocols for emergency presentations. Eur J Emerg Med 23(1):2–7CrossRefPubMed
3.
Shokeir AA (2002) Renal colic: new concepts related to pathophysiology, diagnosis and treatment. Curr Opin Urol 12(4):263–269CrossRefPubMed
4.
Pedersen KV, Drewes AM, Frimodt-Moller PC, Osther PJ (2010) Visceral pain originating from the upper urinary tract. Urol Res 38(5):345–355CrossRefPubMed
5.
6.
7.
Knoedler JJ, Lieske JC (2016) Non-steroidal anti-inflammatory drugs for renal colic. Lancet 387(10032):1971–1972CrossRefPubMed
8.
Türk C, Petřík A, Sarica K, Seitz C, Skolarikos A, Straub M, Knoll T (2012) EAU guidelines on diagnosis and conservative management of urolithiasis. Eur Urol 69(3):468–474CrossRef
9.
Davenport K, Timoney AG, Keeley FX (2005) Conventional and alternative methods for providing analgesia in renal colic. BJU Int 95(3):297–300CrossRefPubMed
10.
Sivrikaya A, Celik OF, Sivrikaya N, Ozgur GK (2003) The effect of diclofenac sodium and papaverine on isolated human ureteric smooth muscle. Int Urol Nephrol 35(4):479–483CrossRefPubMed
11.
Garduño AL, García IC, González RR (1993) Bloqueo del duodécimonervio intercostal como tratamiento del cólico renoureteral. Rev Mex Urol. 53(4):74–79
12.
Aragon TA, Reyes VF, Herrera G, Manjarrez EG, Gutierrez PC (1994) Eficacia del bloqueo subcostal como tratamiento del cólico nefritico. Rev Mex Urol. 54(5):91–98
13.
Nikiforov S, Cronin AJ, Murray WB, Hall VE (2001) Subcutaneous paravertebral block for renal colic. Anesthesiology 94(3):531–532CrossRefPubMed
14.
Iguchi M, Katoh Y, Koike H, Hayashi T, Nakamura M (2002) Randomized trial of trigger point injection for renal colic. Int J Urol 9(9):475–479CrossRefPubMed
15.
16.
Afshar K, Jafari S, Marks AJ, Eftekhari A, MacNeily AE (2015) Nonsteroidal anti-inflammatory drugs (NSAIDs) and non-opioids for acute renal colic. Cochrane Database Syst Rev 2015(6):CD006027
17.
Pathan SA, Mitra B, Straney LD, Afzal MS, Anjum S, Shukla D et al (2016) Delivering safe and effective analgesia for management of renal colic in the emergency department: a double-blind, multigroup, randomised controlled trial. Lancet 387(10032):1999–2007CrossRefPubMed
18.
KandaSwamy GV, Dhanasekaran AK, Elangovan A, John B, Viswaroop B, Vedanayagam KS (2015) Randomized double blinded placebo controlled trial comparing diclofenac and piroxicam in management of acute renal colic and its clinical implications. Urol J 12(2):2069–2073PubMed
19.
Kaynar M, Koyuncu F, Buldu I, Tekinarslan E, Tepeler A, Karatag T et al (2015) Comparison of the efficacy of diclofenac, acupuncture, and acetaminophen in the treatment of renal colic. Am J Emerg Med 33(6):749–753CrossRefPubMed
20.
Firouzian A, Alipour A, Rashidian-Dezfouli H, Zamani-Kiasari A, Gholipour-Baradari A, Emami-Zeydi A et al (2016) Does lidocaine as an adjuvant to morphine improve pain relief in patients presenting to the ED with acute renal colic? A double-blind randomized controlled trial. Am J Emerg Med 34(3):443–448CrossRefPubMed
21.
Hura G, Knapik P, Sorek-Kubicka G, Maciejewski D (2005) Thoracic paravertebral blockade–history or present time? Wiad Lek 58(3–4):208–211PubMed
22.
Rossikhin VV (1978) Effectiveness of M.N. Astvatsaturov’s block in renal colic. Klin Khir 2:74–75
23.
Puterman NS (1973) Treatment of the renal colic. Vestn Khir Im I I Grek 110(3):113–114PubMed
24.
Eken C, Durmaz D, Erol B (2009) Successful treatment of a persistent renal colic with trigger point injection. Am J Emerg Med 27(2):252-e3CrossRef
25.
Belkouch A, Zidouh S, Rafai M, Chouaib N, Sirbou R, Elbouti A et al (2015) Does intranasal fentanyl provide efficient analgesia for renal colic in adults? Pan Afr Med J 20:407PubMedPubMedCentral
26.
Benitez Camps M, Cerain Herrero MJ, de Miguel Llorente N, Martorell Sole E, Flores Mateo G, Pedro Pijoan AM et al (2015) Tamsulosin efficacy and safety for conservative management of renal colic: systematic review and meta-analysis of randomized controlled trials. Med Clin 145(6):239–247CrossRef
27.
el-Sherif AE, Salem M, Yahia H, al-Sharkawy WA, al-Sayrafi M (1995) Treatment of renal colic by desmopressin intranasal spray and diclofenac sodium. J Urol 153(5):1395–1398
28.
Pricop C, Branisteanu DD, Orsolya M, Puia D, Matei A, Checherita IA (2016) Sublingual desmopressin is efficient and safe in the therapy of lithiasic renal colic. Int Urol Nephrol 48(2):183–189CrossRefPubMed
29.
Faridaalaee G, Mohammadi N, Merghati SZ, Keyghobadi Khajeh F, Naghipour B, Pouraghaei M et al (2016) Intravenous morphine vs intravenous ketofol for treating renal colic; a randomized controlled trial. Emergency. 4(4):202–206PubMedPubMedCentral
30.
Mora B, Giorni E, Dobrovits M, Barker R, Lang T, Gore C et al (2006) Transcutaneous electrical nerve stimulation: an effective treatment for pain caused by renal colic in emergency care. J Urol 175(5):1737–1741 (discussion 41) CrossRefPubMed
31.
Lee YH, Lee WC, Chen MT, Huang JK, Chung C, Chang LS (1992) Acupuncture in the treatment of renal colic. J Urol 147(1):16–18PubMed
32.
Melzack R, Stillwell DM, Fox EJ (1977) Trigger points and acupuncture points for pain: correlations and implications. Pain 3(1):3–23CrossRefPubMed
33.
Fine PG, Milano R, Hare BD (1988) The effects of myofascial trigger point injections are naloxone reversible. Pain 32(1):15–20CrossRefPubMed
34.
Wyant GM (1979) Chronic pain syndromes and their treatment. II. Trigger points. Can Anaesth Soc J 6(3):216–219CrossRef
Metadata
Title
Treatment of reno-ureteral colic by twelfth intercostal nerve block with lidocaine versus intramuscular diclofenac
Authors
Miguel Maldonado-Avila
Marcos Del Rosario-Santiago
Jesus Emmanuel Rosas-Nava
Hugo Arturo Manzanilla-Garcia
Victor Manuel Rios-Davila
Patricia Rodriguez-Nava
Roberto Alejandro Vela-Mollinedo
Mateo Leopoldo Garduño-Arteaga
Publication date
01-03-2017
Publisher
Springer Netherlands
Published in
International Urology and Nephrology / Issue 3/2017
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-016-1479-5

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