A comparative assessment of the clinical efficacy of intranasal desmopressin spray and diclofenac in the treatment of renal colic

The aim of this study was to assess the efficacy of desmopressin nasal spray compared with diclofenac given intramuscularly in patients with acute renal colic caused by urolithiasis. The study included 72 patients randomized into three different groups: group A received desmopressin (40 mg, nasal spray), group B diclofenac (75 mg) intramuscularly and group C, both desmopressin and diclofenac. Pain was assessed using a visual analogue scale at baseline, 10, 30 min and 1 h after administering the treatments. Rescue analgesia was given at 30 min if needed. On admission, the pain level was the same in all three groups (group A 85; and group B and C 90 each). At 10 min the pain decreased minimally in all the groups but more in group B and C (group A 80 and group B and C 70 each). At 30 min pain scores were 75, 37.5 and 40 for group A, B and C, respectively, indicating that there was no significant pain relief in desmopressin group. Rescue analgesic had to be given to all patients in group A and two patients in group B and three patients in group C. Pain relief in the desmopressin only group was significantly less at 1 h even after rescue analgesia (pain scores of 27.5, 15 and 20 for group A, B and C respectively). Intranasal desmopressin is not an effective analgesic in renal colic: exerts mild analgesic effect over a period of 30 min. It does not potentiate the effect of diclofenac.