Table 1
Author, date, and countryPatient groupStudy type (level of evidence)OutcomesKey resultsStudy weaknesses
Nelson CE et al, 1988, Sweden84 patients from two emergency departments with a preliminary diagnosis of acute renal colic who later had diagnosis confirmed by IVU or urine sediment. Patients received one rectal and one IV injection Randomised to receive 100 mg indomethacin PR plus placebo IV injection (riboflavin coloured saline) in 37 patients OR placebo PR plus 50 mg indomethacin intravenously in 47 patientsDouble blind RCTPain severity score (visual analogue scale 0–100) at 0, 10, 20, and 30 minutes after treatment Side effects Need for supplementary analgesiaFaster analgesic effect with IV v rectal at 10 minutes. Effective reduction in mean pain score for both groups (74, 39, 22, 14 for IV v 82, 41, 34, 22 for PR) Significantly more side effects in intravenous group (49%) v rectal group (17%) No significant difference in need for supplementary analgesia 21% IV v 34% PRExcluded patients if could not retain rectal drug therefore did not analyse as intention to treat
Nissen I et al 1990, Denmark116 patients from 10 departments of surgery/urology with clinical symptoms of ureteric colic who were later proven to have a stone on IVU or on passage of stone. Randomised to receive 100 mg indomethacin PR or 50 mg indomethacin IVDouble blind RCTIntensity of pain (visual analogue score 0–100) at 0, 10, 20, and 30 minutes after treatment Adverse events at time of treatment Need for supplementary analgesiaAnalgesia achieved faster in the intravenous group. Significant improvement in mean relative pain intensity in both groups More adverse reactions in intravenous group (44/80, 55%) v PR group (29/79, 37%) (p = 0.03) Need for supplementary analgesia in 27% of PR group v 9% of IV group (p = 0.018)Does not describe how study was randomised. Included 42 patients in analysis of adverse reactions who had no proven diagnosis