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Original Article

The Effect of Aminophylline on Renal Colic: A Randomized Double Blind Controlled Trial

Hooman Djaladat, MD, Parvin Tajik, MD, Salman Abbasi Fard, MD, Sara Alehashemi, MD
Volume: 100 Issue: 11 November, 2007

Abstract:

Objective: To evaluate the efficacy of aminophylline infusion as a painkiller compared with placebo in patients with acute renal colic.


Patients and Methods: From March to August 2005, 141 patients with clinical renal colic, who were under 60 years of age, had no history of heart or hepatic failure, asthma, theophylline or beta blocker use, reaction to methylxantines, pregnancy or breast feeding, and were not prescribed spasmolytic or analgesics, entered our study. They were randomly assigned to receive either 375 mg of aminophylline or placebo infusion under double blind conditions. Pain intensity was recorded using a visual analog scale (VAS), before drug administration and 30 and 60 minutes afterwards. The drug effectiveness was defined as ≥40% decrease in pain intensity 60 minutes after the onset of infusion, without exacerbation during the following 4 hours.


Results: Seventy patients received aminophylline; it was effective in 45 (64%; 95% confidence interval 52–75%). Alternatively, placebo was effective in 12 of 71 control patients (17%; 95% confidence interval 9–28%); (P < 0.001). Thirty and 60 minutes after administration, aminophylline reduced pain by 24% and 39% respectively, as compared with 6% and 8% pain reduction in the placebo group.


Conclusion: This prospective study provides remarkable information about the efficacy of aminophylline on pain relief and decreasing narcotic usage in symptomatic urinary calculi. It is safe, inexpensive, with minute side effects and can be considered a good alternative or additive to narcotic analgesics in the management of renal colic.


Key Points


* The most common symptom of pelvic ureterolithiasis is pain.


* Parenteral administration of narcotic analgesics has been assumed to be the treatment of choice in renal colic patients.


* Aminophylline, an inhibitor of phosphodiesterase, results in smooth muscle relaxation through an increase in cAMP level.


* In a controlled trial, aminophylline was showed to decrease pain intensity significantly in patients with renal colic.

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References:

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