COMPARISON OF KETOROLAC VERSUS DICLOFENAC AS TREATMENT FOR ACUTE RENAL COLIC: A SYSTEMATIC REVIEW AND A NETWORK META-ANALYSIS (DIRECT AND INDIRECT COMPARISON)

Acute renal colic is one of the most frequent urologic visits in Emergency Department (ED), and early management should focus on early relief of pain. Non-steroidal anti-inflammatory drugs (NSAIDs), opiates, or combination of both are often used to treat this condition. Diclofenac is stated in European Association of Urology (EAU) guideline as first line treatment. Interestingly, it is ketorolac that currently the most common analgesics used in most EDs. A meta-analysis study was designed to investigate whether ketorolac or diclofenac is a better NSAID for early pain relief in acute renal colic patients. Relevant studies were obtained from PubMed, Science Direct, Cochrane, EBSCO, and Proquest. Based on current studies, both ketorolac and diclofenac are found superior than pethidine, while both providing a comparable pain relief with diclofenac regarded as a safer option. Further prospective data is needed in Indonesian clinical settings for its assurance in efficacy and safety