Efficacy of Combined Tramadol with Diclofenac in Comparison with Monotherapy Treatment Using Buscopan Diclofenac or Tramadol in Renal Pain Control


Acute renal colic is a severe painful event; drugs used to treat this condition include anticholinergics, opioid analgesics and nonsteroidal anti-inflammatory drugs.To compare drug's efficacy in ureteric pain relief byusing monotherapy including Buscopan 20 mg IV, Diclofenac Sodium 75 mg IM and Tramadol 50 mg IV, with a combination of 2 drugs including Tramadol plus Diclofenac.160 patients (110 males and 50 females), 16 to 75 years of age, with moderate to severe renal pain were treated in emergency department of Hilla Teaching General Hospital and private clinics. Parameters were observed after 10, 30, 60, minutes and 2 hours of drugs treatment. Assessment of analgesic effect of the drugs was done by using Numerical Rating Scale (NRS). Drug side effects also observed.Buscopan was the least effective drug in pain relief with higher side effects, while Diclofenac and Tramadol have comparable efficacy. Combination of Diclofenac plus Tramadol had a significant efficacy with rapid and sustained pain relief.Incidence of ureteric colic are more common in males than females (male to female ratio is 3/1).For quick pain relief in acute renal colic, a combination of intravenous tramadol with diclofenac sodium is superior to each of them alone, while Buscopan is the least effective, with higher side effects.