Journal of education and health promotion · 2026
Comparing the pain relief effectiveness of intravenous magnesium sulfate and ketorolac versus intravenous morphine and ketorolac for kidney stones.
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Bagher Sheydaei Mehdi Fallah, Baghernezhad Ahmad R, Bakhtiari Ali, Rezaei Faezeh
Аннотация
BACKGROUND: Pain is one of the most common symptoms in various diseases. While morphine is widely used for pain relief, its adverse effects and potential for misuse have led to the exploration of safer alternatives. This study aimed to compare the analgesic effectiveness of intravenous magnesium sulfate versus morphine, both in combination with ketorolac, in patients with renal colic.
MATERIALS AND METHODS: In this double-blind randomized controlled trial, 174 patients with renal colic referred to the emergency department of Shahid Ganjiyan Hospital in Dezful were enrolled. Patients were randomly allocated into two equal groups (n = 87). The intervention group received intravenous magnesium sulfate (50 mg/kg diluted in 100 mL normal saline over 15 minutes) plus ketorolac (30 mg), while the control group received intravenous morphine (0.1 mg/kg) plus ketorolac (30 mg). Pain intensity was measured using the Visual Analog Scale (VAS) at baseline (admission), and 20, 40, and 60 minutes after drug administration. Demographic data were also collected.
RESULT: Among the 174 participants included in the study, 65% were male and aged between 40 and 60 years. Statistical tests indicated no significant differences between the two groups concerning demographic characteristics. Thus, the groups are comparable in terms of demographic variables. Comparison of pain reduction between the two groups at different time points revealed no statistically significant difference. The mean pain scores decreased over time in both groups; however, the differences between the groups were not significant at 20 minutes (P = 0.45), 40 minutes (P = 0.74), or 60 minutes post-intervention (P = 0.65). These findings indicate that both treatment protocols (morphine plus ketorolac and magnesium sulfate plus ketorolac) had similar effects on pain reduction at all measured intervals.
CONCLUSION: The findings of this study demonstrate that intravenous magnesium sulfate, in combination with ketorolac, is as effective as morphine-based regimens in managing acute renal colic pain. Given the current global health policies emphasizing opioid stewardship and the reduction of opioid-related adverse effects, magnesium sulfate emerges as a valuable, low-risk alternative. Its incorporation into emergency pain management protocols may not only reduce opioid dependency and misuse but also align with broader public health goals aimed at promoting safer and more sustainable pain relief strategies. Health policymakers should consider including non-opioid analgesics like magnesium sulfate in national and institutional guidelines for acute pain management, especially in settings where opioid overuse presents a clinical and social challenge.
MATERIALS AND METHODS: In this double-blind randomized controlled trial, 174 patients with renal colic referred to the emergency department of Shahid Ganjiyan Hospital in Dezful were enrolled. Patients were randomly allocated into two equal groups (n = 87). The intervention group received intravenous magnesium sulfate (50 mg/kg diluted in 100 mL normal saline over 15 minutes) plus ketorolac (30 mg), while the control group received intravenous morphine (0.1 mg/kg) plus ketorolac (30 mg). Pain intensity was measured using the Visual Analog Scale (VAS) at baseline (admission), and 20, 40, and 60 minutes after drug administration. Demographic data were also collected.
RESULT: Among the 174 participants included in the study, 65% were male and aged between 40 and 60 years. Statistical tests indicated no significant differences between the two groups concerning demographic characteristics. Thus, the groups are comparable in terms of demographic variables. Comparison of pain reduction between the two groups at different time points revealed no statistically significant difference. The mean pain scores decreased over time in both groups; however, the differences between the groups were not significant at 20 minutes (P = 0.45), 40 minutes (P = 0.74), or 60 minutes post-intervention (P = 0.65). These findings indicate that both treatment protocols (morphine plus ketorolac and magnesium sulfate plus ketorolac) had similar effects on pain reduction at all measured intervals.
CONCLUSION: The findings of this study demonstrate that intravenous magnesium sulfate, in combination with ketorolac, is as effective as morphine-based regimens in managing acute renal colic pain. Given the current global health policies emphasizing opioid stewardship and the reduction of opioid-related adverse effects, magnesium sulfate emerges as a valuable, low-risk alternative. Its incorporation into emergency pain management protocols may not only reduce opioid dependency and misuse but also align with broader public health goals aimed at promoting safer and more sustainable pain relief strategies. Health policymakers should consider including non-opioid analgesics like magnesium sulfate in national and institutional guidelines for acute pain management, especially in settings where opioid overuse presents a clinical and social challenge.