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. 2025 Feb 11;87(2):565-570.
doi: 10.1097/MS9.0000000000002934. eCollection 2025 Feb.

Efficacy and safety of ketorolac and dexamethasone for preventing renal colic post stent removal: a randomized triple-blind, placebo-controlled clinical trial

Shaghayegh Mahmoudiandehkordi  1 , Reza Morovatshoar  2 , Pedram Hadipour  3 , Shahnaz Fooladi Sarabi  4 , Mahta Fadaei  5 , Abtin Ansari  6 , Mohammad Farhadi-Shahi  7 , Mohammadreza Noroozi  7
Affiliations

Efficacy and safety of ketorolac and dexamethasone for preventing renal colic post stent removal: a randomized triple-blind, placebo-controlled clinical trial

Shaghayegh Mahmoudiandehkordi et al. Ann Med Surg (Lond). .

Abstract

Background: Renal colic following stent removal post-ureteroscopy is a significant clinical issue. This study aims to evaluate the efficacy and safety of intramuscular ketorolac and dexamethasone in preventing renal colic after stent removal.

Methods: A randomized, triple-blind, placebo-controlled clinical trial was conducted with 147 patients. Participants were allocated to three groups: ketorolac only, ketorolac plus dexamethasone, and placebo. The primary outcome was the visual analog scale (VAS) score for pain, assessed at 1- and 7-days post-stent removal. Secondary outcomes included opioid use, emergency department visits, renal colic symptoms, and missed workdays.

Results: The combination group (ketorolac and dexamethasone) demonstrated significantly lower VAS scores at 24 hours compared to the placebo group (2.95 vs. 4.30, P = 0.008). Additionally, this group had fewer emergency department visits (2.0% vs. 22.4%, P = 0.010) and lower incidences of subjective renal colic (2.0% vs. 20.4%, P = 0.017). No significant differences were observed at 7 days post-stent removal.

Conclusion: Intramuscular ketorolac and dexamethasone significantly reduce pain and related complications following stent removal, providing an effective alternative to opioid analgesics.

Keywords: dexamethasone; ketorolac; pain management; renal colic; stent removal.

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Conflict of interest statement

All authors have no conflict of interest related to this work to report.

Figures

Figure 1.
Figure 1.
Flow diagram of the study.
Figure 2.
Figure 2.
VAS scores at day 1 and day 7 for study groups.
See this image and copyright information in PMC

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