Exploring intradermal sterile water injection as an alternative to natrium diclofenac for kidney-stone related pain relief: A systematic review and meta-analysis of randomized controlled trials.

IF 0.8 Q4 UROLOGY & NEPHROLOGY
Satria Gohtama, Malvin Thaniel, Livia Janice, Michael Rulando, Elvan Wiyarta
{"title":"Exploring intradermal sterile water injection as an alternative to natrium diclofenac for kidney-stone related pain relief: A systematic review and meta-analysis of randomized controlled trials.","authors":"Satria Gohtama, Malvin Thaniel, Livia Janice, Michael Rulando, Elvan Wiyarta","doi":"10.1177/03915603241287033","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Kidney stone-related pain often presents significant challenges in clinical practice, mainly due to the adverse effects by NSAIDs, which are the current first-line treatment for urolithiasis. Patients presenting with gastrointestinal tract disorders and contraindications toward NSAIDs are particularly susceptible. Intradermal sterile water injection (SWI) has evidently become apparent as one of the promising alternatives, offering rapid pain relief with minimal adverse effects. This purpose of this study to assess the safety and efficacy of SWI in comparison to NSAIDs particularly Natrium Diclofenac in the management of kidney-stone related pain.</p><p><strong>Main body: </strong>A systematic review and meta-analysis was performed on papers published up to January 2024 obtained from scientific databases, guided by the PRISMA flowchart. The Cochrane risk of bias 2.0 tool was used to assess quality of the included studies. Statistical analyses were then performed using Review Manager 5.4.1 on studies that provide the baseline and complete follow-up numerical outcomes (e.g. mean and standard deviation) required. After screening was done, 3 retrievable studies met the inclusion and exclusion criteria with a total of 770 participants with kidney stone related pain. The result revealed no significant difference in pain reduction between SWI and Natrium diclofenac at 30 min (MD -0.12, 95% CI -0.68 to 0.44) and 60 min (MD -0.23, 95% CI -0.65 to 0.18). Furthermore, patients treated with SWI display a reduced need for rescue analgesia compared to Natrium Diclofenac (OR 0.73, 95% CI 0.36 to 1.49). Adverse events result was more superior in SWI, having lower occurrence when compared to Natrium Diclofenac, although not significant (OR 0.14, 95% CI 0.05 to 0.39).</p><p><strong>Conclusions: </strong>Intradermal sterile water injection (SWI) appears to be a promising alternative to NSAIDs for kidney stone related pain management, offering comparable efficacy in pain reduction, reduced need for rescue analgesia while maintaining a favorable safety profile. However, further research with larger sample sizes and standardized treatment protocols are required to further validate its safety and efficacy.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"3915603241287033"},"PeriodicalIF":0.8000,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Urologia Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/03915603241287033","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Kidney stone-related pain often presents significant challenges in clinical practice, mainly due to the adverse effects by NSAIDs, which are the current first-line treatment for urolithiasis. Patients presenting with gastrointestinal tract disorders and contraindications toward NSAIDs are particularly susceptible. Intradermal sterile water injection (SWI) has evidently become apparent as one of the promising alternatives, offering rapid pain relief with minimal adverse effects. This purpose of this study to assess the safety and efficacy of SWI in comparison to NSAIDs particularly Natrium Diclofenac in the management of kidney-stone related pain.

Main body: A systematic review and meta-analysis was performed on papers published up to January 2024 obtained from scientific databases, guided by the PRISMA flowchart. The Cochrane risk of bias 2.0 tool was used to assess quality of the included studies. Statistical analyses were then performed using Review Manager 5.4.1 on studies that provide the baseline and complete follow-up numerical outcomes (e.g. mean and standard deviation) required. After screening was done, 3 retrievable studies met the inclusion and exclusion criteria with a total of 770 participants with kidney stone related pain. The result revealed no significant difference in pain reduction between SWI and Natrium diclofenac at 30 min (MD -0.12, 95% CI -0.68 to 0.44) and 60 min (MD -0.23, 95% CI -0.65 to 0.18). Furthermore, patients treated with SWI display a reduced need for rescue analgesia compared to Natrium Diclofenac (OR 0.73, 95% CI 0.36 to 1.49). Adverse events result was more superior in SWI, having lower occurrence when compared to Natrium Diclofenac, although not significant (OR 0.14, 95% CI 0.05 to 0.39).

Conclusions: Intradermal sterile water injection (SWI) appears to be a promising alternative to NSAIDs for kidney stone related pain management, offering comparable efficacy in pain reduction, reduced need for rescue analgesia while maintaining a favorable safety profile. However, further research with larger sample sizes and standardized treatment protocols are required to further validate its safety and efficacy.

探索皮内无菌水注射替代那曲双氯芬酸缓解肾结石相关疼痛:随机对照试验的系统回顾和荟萃分析。
背景:肾结石相关疼痛常常给临床实践带来巨大挑战,主要原因是非甾体抗炎药的不良反应,而非甾体抗炎药是目前治疗尿路结石的一线药物。患有胃肠道疾病和非甾体抗炎药禁忌症的患者尤其容易受到影响。皮内无菌水注射(SWI)显然是很有前途的替代疗法之一,它能快速缓解疼痛,且不良反应极小。本研究旨在评估皮内无菌水注射与非甾体抗炎药(尤其是那曲双氯芬酸)相比,在治疗肾结石相关疼痛方面的安全性和有效性:在 PRISMA 流程图的指导下,对科学数据库中截至 2024 年 1 月发表的论文进行了系统综述和荟萃分析。科克伦偏倚风险 2.0 工具用于评估纳入研究的质量。然后使用 Review Manager 5.4.1 对提供基线和完整随访数字结果(如平均值和标准偏差)的研究进行统计分析。经过筛选,有 3 项可检索的研究符合纳入和排除标准,共有 770 名肾结石相关疼痛的参与者。结果显示,在 30 分钟(MD -0.12,95% CI -0.68-0.44)和 60 分钟(MD -0.23,95% CI -0.65-0.18)时,SWI 和 Natrium 双氯芬酸在减轻疼痛方面无明显差异。此外,与Natrium双氯芬酸相比,使用SWI治疗的患者减少了对镇痛抢救的需求(OR为0.73,95% CI为0.36至1.49)。与Natrium Diclofenac相比,SWI的不良事件发生率更低,但并不显著(OR值为0.14,95% CI为0.05至0.39):皮内无菌水注射(SWI)似乎是替代非甾体抗炎药治疗肾结石相关疼痛的一种很有前景的方法,在减轻疼痛方面具有相当的疗效,减少了对解救性镇痛的需求,同时保持了良好的安全性。然而,要进一步验证其安全性和有效性,还需要进行更大规模的样本研究和标准化治疗方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Urologia Journal
Urologia Journal UROLOGY & NEPHROLOGY-
CiteScore
0.60
自引率
12.50%
发文量
66
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信