Lornoxicam versus diclofenac sodium in acute renal colic: a prospective randomized trial

Acute renal colic is probably the most excruciatingly painful event a person can endure. The pain is often described as being worse than childbirth, broken bones, gunshot wounds, burns, or surgery. Renal colic affects approximately 1.2 million people each year and accounts for approximately 1% of all hospital admissions in emergency and casualty ward. The pain generated by renal colic is primarily caused by the dilation, stretching, spasm, ureteral peristalsis, stone migration, and tilting or twisting of the stone with subsequent intermittent obstructions leading to exacerbation or renewal of renal colic pain. The most effective pain relief is achieved after relieving the obstruction by spontaneous passage or surgical removal of renal calculus. 1 Opioid and nonsteroidal anti-inflammatory drugs (NSAIDS) remain the mainstay of treatment for acute renal colic. However; prolonged opioid use may cause dependence, tolerance and side-effects like nausea, vomiting, constipation and drowsiness. Larger doses even cause respiratory depression and hypotension. Diclofenac is amongst the most extensively used NSAIDs still preferred first line drug in renal colic pain. Another class of drug which has shown the efficacy in renal colicky pain is oxicam derivatives. Both piroxicam and tenoxicam have been extensively used, recently lornoxicam has been introduced in Indian market in oral, intravenous and intramuscular formulations. There is plenty of literature available on the effect of lornoxicam on chronic and acute pain management. 2