Methodology: 4/5
Usefulness: 3.5/5
Toumia M, et al. Ann Emerg Med. 2024 Dec;84(6):670-677. doi: 10.1016/j.annemergmed.2024.06.015.
Question and Methods: This double-blinded RCT studied whether using adjuncts including MgSO4 and lidocaine are more effective than NSAID therapy alone for acute renal colic in the ED.
Findings: A 50% reduction in pain at 30 minutes was seen in the MgSO4 group (81.7%) compared to NSAIDs alone (71.8%) with a reduction in need for rescue analgesia (17.1% vs 28.9%). However, the pain reduction did not achieve clinical significance. All outcomes were unremarkable for IV lidocaine. Â
Limitations:Â This study assesses one dosing regimen therefore making it unclear whether higher doses of MgSO4 may be more effective as an alternative to opioids.Â
Interpretation: The mainstay of pain management for renal colic in the ED includes NSAIDs and further studies are required to determine effectiveness of adjuncts over opioids.
JC Supervisor: Dr. Venkatesh Thiruganasambandamoorthy
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