Paracetamol, parecoxib show promise in acute renal colic

In the treatment of patients with acute renal colic, paracetamol and parecoxib are equally effective at dulling pain, reducing the need for rescue analgesia with minimal adverse events, as shown in a study.

The analysis included 203 patients who presented to the emergency department with acute renal colic secondary to ureteric stones. They were randomized to receive 1-g paracetamol infusion (n=102) or 40-mg parecoxib infusion (n=101). Pain analogue score was evaluated before treatment and 30 minutes after treatment.

Baseline patient data were comparable between the two groups. None of the patients had hypersensitivity to either drug, peptic ulcer, coronary ischaemia, peripheral vascular or cerebrovascular disease, hepatic impairment (Child-Pugh score >10), or chronic kidney disease stage 4 or 5.

Both drugs provided significant pain relief. The mean pain analogue score decreased from 7.6 at baseline to 3.8 post-treatment in the paracetamol group (p<0.001) and from 7.8 to 3.4 in the parecoxib group (p<0.001).

The number of patients who required rescue analgesia for persistent pain, the primary study endpoint, was comparable: 36 in the paracetamol group and 27 in the parecoxib group (35.3 percent vs 26.7 percent, respectively; p=0.187).

Both drugs were relatively safe. Minor adverse events occurred in two patients on paracetamol and three patients on parecoxib (p=0.683).