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

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.