Compression of the Analgesic Effects of Intravenous Metoclopramide and Ondansetron in combination on Renal Colic in the Patients receiving Morphine

The aim of this study was to compare the analgesic effects of I.V. ondansetron and I.V. metoclopramide in combination with morphine in relieving pain in the patients with acute renal colic receiving morphine in the emergency department.

Patients were randomly divided into three groups of A, B and C. Group A patients were treated with 0.1 mg/kg intravenous morphine and 0.075 mg/kg I.V. ondansetron (maximum 4 mg), group B patients were treated with the same dose of intravenous morphine and 0.15 mg/kg metoclopramide (maximum 10 mg) and group C patients received the same dose of intravenous morphine and 5 cc normal saline. Pain intensity was assessed at the beginning of the study and 15, 30, 60 and 120 minutes after receiving the drug by Visual Analog Scale (VAS).

In this study, 150 patients were divided into three groups. The mean age of patients was 34.51 ± 7.84. There was no significant difference between the three groups in terms of gender distribution (P = 0.737) and mean age (P = 0.57). The mean VAS score was not significantly different in the three groups at the beginning of the study (P=0.338). But at the 15th minute VAS scores in the metoclopramide and ondansetron groups were significantly less than that of the control group (P=0.044). At the 30th minute, the difference in the pain intensity among the three groups was again insignificant (P=0.164). But at the 60th and 120th minutes, the VAS score in the metoclopramide group was significantly less than those of the other two groups. (P=0.033 and P=0.009). Also, intragroup analysis showed a significant decreasing trend in the VAS scores in the three groups during the study (P <0.001). Patient’s average length of stay in emergency department was 53±18 minutes in the metoclopramide group, 72±31 minutes in the ondansetron group and 80±31 minutes in the control group (P <0.001). In the metoclopramide group, 2 patients developed extrapyramidal complications.

Our findings indicated that metoclopramide and ondansetron in addition to their antiemetic effects, have analgesic effects. The analgesic and antiemetic effects of metoclopramide and its effect on reducing the length of hospital stay were greater than those of ondansetron