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Forced versus minimal intravenous hydration in the management of acute renal colic: a randomized trial.

Publication ,  Journal Article
Springhart, WP; Marguet, CG; Sur, RL; Norris, RD; Delvecchio, FC; Young, MD; Sprague, P; Gerardo, CA; Albala, DM; Preminger, GM
Published in: J Endourol
October 2006

BACKGROUND AND PURPOSE: The management of acute renal colic is a problem commonly encountered by both urologists and emergency medicine physicians. The classic approach to managing uncomplicated acute renal colic involves hydration, along with imaging and pain control. Previous studies have suggested that hydration has a significant impact on patient comfort, as well as spontaneous stone passage. This study evaluated the effects of maintenance v forced hydration and its effect on the pain experienced from renal colic. PATIENTS AND METHODS: Forty male and 18 female patients with a mean age of 41 years suspected to have acute renal colic were identified in the emergency department. After screening and informed consent, the patients were enrolled in the study, and 43 patients were eventually available for analysis. Patients received intravenous (IV) analgesia, imaging with a noncontrast CT scan of abdomen and pelvis, and assignment to either forced IV hydration with 2 L of normal saline over 2 hours (N = 20) or minimal IV hydration at 20 mL of normal saline per hour (N = 23). A visual analog pain scale was completed hourly for a total of 4 hours. Demographic information, laboratory and imaging results, narcotic use in morphine equivalents (ME), and pain scores were recorded and compared. Spontaneous stone passage rates were also calculated by careful patient follow-up. Results were considered statistically significant at p < 0.05. RESULTS: Stone size was equivalent in the two treatment groups (p > 0.05). There was no difference in the narcotic requirement in ME (p = 0.644) between the two groups. Similarly, there was no difference in hourly pain score or stone-passage rates between the groups (p > 0.05). CONCLUSIONS: Treatment of uncomplicated renal colic has traditionally included vigorous intravenous hydration, as well as medications for the control of pain and nausea. Our data suggest that maintenance intravenous fluids are as efficacious as forced hydration with regard to patient pain perception and narcotic use. Moreover, it appears the state of hydration has little impact on stone passage.

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Published In

J Endourol

DOI

ISSN

0892-7790

Publication Date

October 2006

Volume

20

Issue

10

Start / End Page

713 / 716

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Treatment Outcome
  • Tomography, X-Ray Computed
  • Pain Measurement
  • Middle Aged
  • Male
  • Kidney Calculi
  • Humans
  • Fluid Therapy
  • Female
 

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Springhart, W. P., Marguet, C. G., Sur, R. L., Norris, R. D., Delvecchio, F. C., Young, M. D., … Preminger, G. M. (2006). Forced versus minimal intravenous hydration in the management of acute renal colic: a randomized trial. J Endourol, 20(10), 713–716. https://doi.org/10.1089/end.2006.20.713
Springhart, W Patrick, Charles G. Marguet, Roger L. Sur, Regina D. Norris, Fernando C. Delvecchio, Matthew D. Young, Paula Sprague, Charles A. Gerardo, David M. Albala, and Glenn M. Preminger. “Forced versus minimal intravenous hydration in the management of acute renal colic: a randomized trial.J Endourol 20, no. 10 (October 2006): 713–16. https://doi.org/10.1089/end.2006.20.713.
Springhart WP, Marguet CG, Sur RL, Norris RD, Delvecchio FC, Young MD, et al. Forced versus minimal intravenous hydration in the management of acute renal colic: a randomized trial. J Endourol. 2006 Oct;20(10):713–6.
Springhart, W. Patrick, et al. “Forced versus minimal intravenous hydration in the management of acute renal colic: a randomized trial.J Endourol, vol. 20, no. 10, Oct. 2006, pp. 713–16. Pubmed, doi:10.1089/end.2006.20.713.
Springhart WP, Marguet CG, Sur RL, Norris RD, Delvecchio FC, Young MD, Sprague P, Gerardo CA, Albala DM, Preminger GM. Forced versus minimal intravenous hydration in the management of acute renal colic: a randomized trial. J Endourol. 2006 Oct;20(10):713–716.
Journal cover image

Published In

J Endourol

DOI

ISSN

0892-7790

Publication Date

October 2006

Volume

20

Issue

10

Start / End Page

713 / 716

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Treatment Outcome
  • Tomography, X-Ray Computed
  • Pain Measurement
  • Middle Aged
  • Male
  • Kidney Calculi
  • Humans
  • Fluid Therapy
  • Female