Local heat decreases renal colic pain

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Local heat decreases renal colic pain

J Fam Pract. 2003 November;52(11):828-848

By

Cristen Page, MD, MPH

Warren Newton, MD, MPH

BACKGROUND: Renal colic is common in primary care, but pain management is often unsatisfactory. This randomized controlled trial examined the use of local heat for the treatment of pain, anxiety, and nausea associated with renal colic.
POPULATION STUDIED: This study enrolled 100 otherwise healthy European patients, aged 19 to 40 years, with abdominal pain suspected to be secondary to renal colic while being transported to the emergency department by paramedics. Subjects were those with a history of urolithiasis with new side and lower back pain measured at >60 on a visual analog scale of 0 to 100, comparable with their last episode of urolithiasis. Patients were excluded if they had cognitive impairment or problems with normal communication. The average patient was aged 28 years and had a pain score of 82/100.
STUDY DESIGN AND VALIDITY: The study was a prospective randomized controlled trial. Enrollment took place before transport. Patients in the experimental group were covered on the lateral abdomen and lower back by an electric blanket set at 42°C; control patients had the same arrangement without activation of the blanket. The controls were set and locked in a box.
OUTCOMES MEASURED: Primary outcomes were patient ratings of pain, nausea, and anxiety using a visual analog scale of 0 mm (no pain) to 100 mm (the most intense pain imaginable). Other outcomes were patient satisfaction, core temperature, blood pressure, and heart rate. Pertinent outcomes not addressed include adverse effects of treatment, cost, provider satisfaction, and need for pain medications after transport.
RESULTS: The researchers found no significant baseline differences between the 2 groups after randomization and follow-up was complete. Patients receiving local heat reported a significant decrease in averages of pain (83 mm to 36 mm; P<.01), anxiety (79 mm to 31 mm; P<.01), and nausea (86 mm to 41 mm; P<.01), whereas the patients in the control group showed no significant changes. All subjects receiving local heat had a greater than 50% reduction in their score for pain (number needed to treat=1).

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Local heat decreases renal colic pain

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