From the Guidelines
The emergency department treatment for renal colic should prioritize analgesia with diclofenac given by intramuscular injection to provide rapid pain relief within half an hour, as recommended by the consensus group’s findings 1. The goal of treatment is to manage pain, reduce inflammation, and facilitate stone passage while minimizing morbidity and mortality.
- Pain management is crucial, and the use of diclofenac by intramuscular injection is favored for its effectiveness in providing rapid pain relief, as supported by the study 1.
- Assessment of the patient should include examination of the abdomen, vital signs, and urinalysis to exclude other conditions and identify potential complications, as outlined in the study 1.
- Hydration and maintaining a high fluid intake are also essential for facilitating stone passage and reducing the risk of further complications.
- The study 1 emphasizes the importance of investigating all patients with suspected acute renal colic to identify the calculus and determine management, which may involve urologic consultation and further treatment.
- Patients with severe pain, signs of infection, or complete obstruction may require more aggressive treatment, including hospital admission and urologic intervention, as indicated by the study's recommendations for failure of analgesia and recurrent pain 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
ED Treatment for Renal Colic
The emergency department (ED) treatment for renal colic typically involves the use of analgesics to manage pain.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used for this purpose, as they have been shown to be effective in reducing pain associated with renal colic 2, 3, 4, 5, 6.
- Specific NSAIDs that have been studied for the treatment of renal colic include ketorolac 2, 3 and diclofenac 4.
- The use of ketorolac has been found to be effective in reducing pain in patients with renal colic, with studies showing significant reductions in pain scores within 30-60 minutes of administration 2, 3.
- Diclofenac has also been found to be effective in managing pain associated with renal colic, with no significant difference in efficacy compared to ketorolac 4.
- Opioids and paracetamol (acetaminophen) may also be used for pain management in renal colic, but NSAIDs are generally preferred due to their efficacy and safety profile 6.
- The choice of analgesic and dosage may depend on individual patient factors, such as medical history and severity of symptoms.
- It is essential to note that the treatment of renal colic should be tailored to the individual patient's needs and medical history, and may involve a combination of analgesics and other therapies.