Comparison of the efficacy of diclofenac, acupuncture, and acetaminophen in the treatment of renal colic

Objective: The objective is to compare the analgesic effects of diclofenac, acetaminophen, and acupuncture in urolithiasis-driven renal colic pain relief. Methods: Renal colic patients were divided randomly into 3 groups. Patients in group I (n = 40) were treated with intravenous acetaminophen, those in group II (n = 41) with acupuncture, and those in group III (n = 40) with a 75-mg intramuscular injection diclofenac sodium. Visual analogue scale (VAS) and verbal rating scale (VRS) were used to assess pain intensity after 10, 30, 60, and 120 minutes. Results: No significant differences in baseline VAS or VRS were found with regard to age or sex. After 10 minutes, all 3 groups experienced a significant decrease in VAS and VRS scores, with the most drastic decrease occurring in group II. After 30 minutes, there was a significantly higher decrease in group III than in group I (P=.001). After 60 minutes, mean VAS scores of groups I and III (P=.753) were similar. The mean VAS score of group III was lower than that of group II (P=.013). After 120 minutes, the difference in the VAS scores was (P=.000) between groups I and II and between groups II and III. Yet, the VAS evaluation made after 120 minutes revealed statistically similar outcomes for groups I and III (P=.488). The statistical findings for VRS evaluations made after 10, 30, 60, and 120 were similar to those for VAS. Conclusions: In renal colic patients with a possible nonsteroidal anti-inflammatory drug and acetaminophen side effect risk, acupuncture emerges as an alternative treatment modality. (C) 2015 Elsevier Inc. All rights reserved.