Efficacy and safety of ketorolac and dexamethasone for preventing renal colic post stent removal: a randomized triple-blind, placebo-controlled clinical trial.

Abstract

Background: Renal colic following stent removal post-ureteroscopy is a significant clinical issue. This study aims to evaluate the efficacy and safety of intramuscular ketorolac and dexamethasone in preventing renal colic after stent removal.

Methods: A randomized, triple-blind, placebo-controlled clinical trial was conducted with 147 patients. Participants were allocated to three groups: ketorolac only, ketorolac plus dexamethasone, and placebo. The primary outcome was the visual analog scale (VAS) score for pain, assessed at 1- and 7-days post-stent removal. Secondary outcomes included opioid use, emergency department visits, renal colic symptoms, and missed workdays.

Results: The combination group (ketorolac and dexamethasone) demonstrated significantly lower VAS scores at 24 hours compared to the placebo group (2.95 vs. 4.30, P = 0.008). Additionally, this group had fewer emergency department visits (2.0% vs. 22.4%, P = 0.010) and lower incidences of subjective renal colic (2.0% vs. 20.4%, P = 0.017). No significant differences were observed at 7 days post-stent removal.

Conclusion: Intramuscular ketorolac and dexamethasone significantly reduce pain and related complications following stent removal, providing an effective alternative to opioid analgesics.