The effect of clinical follow-up treatment and bedside ultrasonography assessment of renal colic patients in emergency service

AIM: In this study, the effects on ultrasound findings and pain scales of the analgesic combination therapies administered to the patients with renal colic in the emergency department were investigated. MATERIAL AND METHOD: This study was prospectively performed on 100 patients presenting with renal colic between September 2013 and September 2014 in the Emergency Department of Gaziantep University Medical Faculty. Patients were divided into 4 groups of 25 people that applied tramadol, dexketoprofen, tramadol –midazolam combination and midazolam –dexketoprofen combination. Arterial blood pressure, pulse rate, bedside renal ultrasonography (USG) were evaluated. Pain levels that scaled by using Visual Analogue Scale (VAS) and Renal Colic Symptom Score (RKSS) were recorded before the treatment (0. minute) and after the treatment (30. minute ). These values were compared. SPSS 18.0 for Windows (SPSS Inc, Chicago, Illinois, USA) software package was used for statistical analysis and p <0.05 was considered statistically significant in all comparisons. FINDINGS: There were no statistically significant differences between the groups in terms of sex and age (p = 0.951 and p = 0.890). There were no statistically significant differences in urea, creatinine, white blood cell values (p = 0.403, p = 0.261 and p = 0.780). Red blood cells in the urine tests were observed in 70% of patients. A significant decrease was observed on VAS and RKSS values before the treatment (0.minute) and after the treatment (30.minute), in all groups. The maximum decrease was in the tramadol-midazolam combination group between group comparisons. Unlike the other groups, both systolic and diastolic blood pressure values were statistically significantly lower in the tramadol-midazolam combination group after the treatment (30.minute). The maximum changes were seen in the measurement of sore side renal parenchyma diameters in the tramadol-midazolam combination group and there were no changes in the other parameters of bedside renal USG. CONCLUSION AND RESULTS: Bedside USG and RKSS scoring system should be used when evaluating patients with acute renal colic in the emergency department. In addition to the analgesic drugs, anxiolytic and sedative drugs should be added to the treatment.