Renal of 0.1 mg/Kg morphine sulfate and 30

Renal colic is a sudden onset severe pain that initiated from flanks and radiated to the groin.

The patients experience a increasing recurrent pain. The mail goal in the treatment is alleviation of pain. Ketorolac is NSAID with analgesics and anti inflammatory effects that frequently used in patients with renal colic. The drug controlled pain and inflammation by inhibition of prostaglandins synthesis(12). In the emergency department it administered routinely.

But it could be caused upper gastrointestinal bleeding, gastric ulcers, hemostatic impairment, renal dysfunction and bronchospasm. Hence it is contraindicated in some predisposed patients(13).Moreover, its analgesic effect is short term and usually patients re-admited to the ED. So, the emergency physicians are seeking for a more effective analgesic in controlling the renal colic pain. In the current study, we have aimed to evaluate the effect of magnesium sulphate as an adjunct to Ketorolac in the alleviating renal colic pain. Our results showed that, baseline pain score(before intervention)  in the control and intervention groups were 7.56 and 7.

81,respectively, that showed insignificantly differences. After 30 minutes pain score significantly reduced in both groups. While, In the time point of 15 minutes and also 30 minutes the VAS did not showed significantly differences between the groups. So, the results indicated that adding magnesium sulphate to Ketorolac did not cause a significant analgesic effect. Joker et al in a similar randomized clinical trial study evaluate the analgesic effects of magnesium sulphate on renal colic pain. They compared the pain severity using VAS in patients either received standard protocol for renal colic pain relief (intravenous infusion of 0.1 mg/Kg morphine sulfate and 30 mg of Ketorolac) with or without magnesium sulphate.

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Contrary to our results they found that mean pain severity on VAS is significantly lower in the groups received magnesium sulphate(14). The differences may be due to the Jokar et al study protocol, they also administrated morphine along with Ketorolac. In the another RCT study, Sun et al assessed the perineural magnesium sulphate analgesic effects for diabetic toe amputation, they showed that MgSO4 as an adjunctive drug did not enhance analgesic quality(15). Similarly, Frassanito et al evaluated the effect of IV magnesium sulfate on postoperative total knee arthroplasty pain severity. They found that perioperative infusion of IV magnesium sulfate could not influence  postoperative pain(16).

Moreover it has been reported that magnesium sulfate did not also effect on opioid consumption(17).Collectively, our finding emphasized that adding magnesium sulfate to Ketorolac could not influence the renal colic pain relief. Short follow up duration and also small sample size are the limitations of our study. We also did not compared the side effects between the groups.

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