Evidence map›Paper›PMID 39763427›Full record

Trial reportEmergency medicine Australasia : EMA2025

Superior efficacy of intramuscular diclofenac compared to intravenous tramadol for acute renal colic in northern Thai patients: A randomised double-blind, sham-controlled trial.

Jarupa Yaowalaorng, Wiracha Kunthasook, Thanin Lokeskrawee, Jayanton Patumanond, Pakpoom Wongyikul, Suppachai Lawanaskol, Narada Udornpim

Abstract readRandomized Controlled TrialEquivalence Trial
In one paragraph

Trial report in Emergency medicine Australasia : EMA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Jarupa YaowalaorngDepartment of Emergency Medicine, Lampang Hospital, Lampang, Thailand.
Wiracha KunthasookDepartment of Emergency Medicine, Lampang Hospital, Lampang, Thailand.
Thanin LokeskraweeDepartment of Emergency Medicine, Lampang Hospital, Lampang, Thailand.
Jayanton PatumanondCenter for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Pakpoom WongyikulCenter for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.ORCID 0000-0003-4998-6977
Suppachai LawanaskolChaiprakarn Hospital, Chiang Mai, Thailand.
Narada UdornpimGifted Mathematics Program, Montfort College, Chiang Mai, Thailand.

Funding

Lampang Hospital
6 · The paper itself

Abstract

objectiveThe present study aimed to compare time to effective pain relief between diclofenac 75 mg intramuscular (IM) and tramadol 50 mg intravenous (IV) for ED patients with acute renal colic.

methodsA randomised, double-blinded, sham-controlled, superiority trial was conducted. Patients diagnosed with acute renal colic (hydronephrosis and/or stone visualisation on point-of-care ultrasound) in the ED were randomly assigned to receive an IM injection of 75 mg of diclofenac or IV tramadol 50 mg. Pain relief was defined as a numerical rating scale reduction of two or more points (standard 0-10 scale) and a reduction of at least one level of pain transition question ('much better', 'little better', 'unchanged', 'little worse', 'much worse'). The primary outcome was the multivariable-adjusted subdistribution-hazard ratio (SHRs) within 120 min in the ED, estimated using the cumulative incidence function (CIF). The secondary outcome compared the average time to pain relief using the restricted mean survival time (RMST).

resultsA total of 68 patients were randomised, with 34 patients allocated to each group. At the 120 min, pain relief was reported in diclofenac and tramadol, 32 (94%) and 22 (65%) patients respectively. SHR was 2.86 (95% CI: 1.80-4.55; P value <0.001). For diclofenac and tramadol, the RMSTs were 37.09 min (95% CI: 30.00, 44.15) and 78.74 min (95% CI: 66.49, 90.99) respectively, with the difference of 41.67 min (95% CI: 55.71, 27.62).

conclusionDiclofenac 75 mg IM provides faster effective pain relief compared with tramadol 50 mg IV.

Indexed as

Anti-Inflammatory Agents, Non-SteroidalDiclofenacRenal ColicTramadolAdministration, IntravenousAdultAnalgesics, OpioidDouble-Blind MethodFemaleHumansInjections, IntramuscularMaleMiddle AgedPain ManagementPain MeasurementSoutheast Asian PeopleAnalgesics, OpioidAnti-Inflammatory Agents, Non-SteroidalDiclofenacTramadoldiclofenacrandomised controlled trialrenal colictramadol

Identifiers

PMID39763427
PMCPMC11704847

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.