Comparison of Intranasal Desmopressin Spray With Intramuscularly Injection of Sodium Diclofenac in Analgesic Therapy of Renal Colic Caused by Calculous

Renal colic due to urinary tract calculous is one of the urology emergencies. However The traditional and standard treatment of renal colic is first narcotics and then non steroid anti inflammatory drugs (NSAIDs) drugs, but studies have shown that other drugs such as desmopressin are used with different effectiveness. This study assessed the efficacy of desmopressin nasal spray compared to sodium diclofenac in treatment of renal colic caused by calculous. In this clinical trial study, 90 patients with renal colic due to urinary stones refferred to the emegency department of Rafsanjan Ali Ebn Abitaleb Hospital were divided randomly into three groups. Group 1 received 40µg of desmopressin nasal spray, group 2, 75 mg of sodium diclofenac intramuscularly and group 3, both desmopressin and diclofenac. Using a visual analogue scale at 10, 20 and 30 min after administering the treatments assessed pain relief that were classified to complete, Moderate, and no pain relief, respectively. The results were analyzed by X2 and Fisher test. In this study 70% of samples were male with mean age 33.6±10.5. At the end of study, 34% of patients reported complete relief, 23% moderate and, the remainders reported no Pain relief. The best response to the treatment was observed in group 3 (desmopressin + diclofenac) (96.7%) which pain relief at 10, 20, 30 min after administration was significantly higher than groups 1 and 2 (p<0.05). The pain relief was same in groups 1 and 2 after 10, 20 minutes, however the effect of desmopressine was more than diclofenac after 10 minutes but after 30 minutes pain relief in group 1 was reduced significant compare to group 2 (p=0.016). It seems that nasal spray desmopressin alone has a rapid but transient on renal colic pain relief but if it is combined with sodium diclofenac, increases the sedation effect.