***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The aim of this study is to compare the effectiveness of the 5-HT3 antagonist , ondansetron and a non-steroidal anti-inflammatory agent , diclofenac sodium , as a pain reliever in the treatment of acute ureteral colic . Sixty four patients with severe or moderate pain who were clinical ly diagnosed as having ureteral colic associated with microscopic or gross hematuria were included in the study . Thirty three patients were administered ondansetron and 31 patients were administered diclofenac sodium .  Exclusion critera were known kidney or liver disease causing dysfunction , known hypersensitivity to ondansetron or diclofenac sodium , pregnancy , lactation , duodenal ulcer or bleeding . After pain assessment with a verbal scale and a visual analog scale ( VAS ) , we r and omized patients and administered 8 mg ondansetron intravenously to 33 patients and 75 mg diclofenac sodium intramuscularly to 31 patients and pain scores were recorded every 15 minutes . If significant pain relief was not achieved within 60 minutes , IV meperidine was given as rescue pain medication . Ondansetron was effective as a primary pain reliever in 14 ( 42.4 % ) patients , whereas 19 patients required additional medication . Diclofenac sodium was effective as a primary pain reliever in 24 ( 77.4 % ) patients , whereas 7 patients required additional medication . Ondansetron was not superior to diclofenac sodium in relieving pain in patients with acute ureteral colic Eighty-six patients with ureteral colic were included in a r and omised , prospect i ve , double-blind study of the analgesic efficacy and tolerance of ketoprofen versus diclofenac , both administered intramuscularly . There were no significant differences regarding pain-relief or side-effects 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 r and omized 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 Objective The aim of this study was to assess the efficacy and safety of a single intravenous ( i.v . ) bolus of dexketoprofen trometamol compared with an i.v . infusion of dipyrone in patients with moderate to severe pain due to renal colic . Methods A total of 308 patients with renal colic and visual analog scale ( VAS ) score ≥40 mm participated in a multicenter , r and omized , double blind , double-dummy , parallel , and active-controlled study and were r and omized to dexketoprofen 25 mg ( n = 101 ) , dexketoprofen 50 mg ( n = 104 ) , and dipyrone 2 g ( n = 103 ) . Results Mean [ ± st and ard deviation ( SD ) ] total pain relief ( TOTPAR ) scores were similar in the dexketoprofen 50 mg ( 15.3 ± 8.6 ) and dipyrone ( 15.5 ± 8.6 ) and slighly higher than in dexketoprofen 25 mg ( 13.5 ± 8.6 ) , although significant differences were not achieved . In the same way , patients in the dexketoprofen 50 mg and dipyrone groups showed higher scores in the sum of pain intensity differences ( SPID ) and the sum of analogue pain intensity differences ( SAPID ) than patients in the dexketoprofen 25 mg group , reaching statistical significance in comparison with dexketoprofen 25 mg and dipyrone for SPID and SAPID ( p < 0.05 ) . The time – effect course for pain intensity differences and pain relief showed significantly higher values for both doses of dexketoprofen during the first 30 min after drug administration ( p < 0.05 ) . Dexketoprofen 50 mg and dipyrone groups had 66 % and 70 % , respectively , of patients with at least 50 % of maximum obtainable TOTPAR in comparison with 56 % in the dexketoprofen 25 mg group . The study medications were well tolerated . Conclusions Dexketoprofen 50 mg administered as a single i.v . bolus was effective for the relief of moderate to severe pain in patients with renal colic , with a good safety profile and efficacy similar to i.v . dipyrone 2 g. Dexketoprofen produced analgesia that was faster in onset Intravenous indoprofen ( 400 mg ) , a cyclooxygenase inhibitor , was compared with intramuscular oxicodone hydrochloride (= oxicone 10 mg ) , a narcotic analgesic agent , in regard to efficacy and side effects in the treatment of renal colic .  Oxicone was combined with papaverine ( 20 mg ) . Patients were r and omized to either treatment , and the drugs were given in double-dummy fashion , i.e. one injection of active drug plus one placebo injection . Pain intensity before and after treatment was registered by the patient ( visual analog scale ) and by a nurse , who also registered side effects . Oxicone was given to 46 patients and indoprofen to 48 . The groups did not differ in body weight , age , sex distribution , or pretreatment intensity of pain .  More patients required additional treatment in the oxicone than in the indoprofen group ( 19 v. 10 ) . At 2 - 5 min after injection , pain reduction was greater with indoprofen , and more patients in this group had pain relief after 3 - 5 hours . Side effects were less frequent with indoprofen than with oxicone ( 1 v. 20 patients ) , in particular from the central nervous system . This difference probably was related to indoprofen 's slow and poor penetration of the blood-brain barrier . The study affirmed that non-narcotic cyclooxygenase inhibitors can replace narcotic analgesics for acute pain alleviation in renal colic . Indoprofen seems to be a useful alternative , with low risk of central nervous side effects Summary To investigate the combined analgesic and spasmolytic effect of dipyrone , 104 patients suffering from “ severe ” or “ excruciating ” colic pain due to a confirmed calculus in the upper urinary tract were r and omized to receive i.v . either 2.5 g dipyrone ( 36 patients ) , 100 mg tramadol ( 35 patients ) , or 20 mg butylscopolamine ( 33 patients ) in a multicentre , observer-blind , parallel-group study conducted in 8 German centres . The three treatment groups were homogeneous when analyzed by age , sex , height , and baseline pain intensity . Dipyrone was significantly more effective than tramadol in reducing pain for the primary endpoint , pain intensity differences ( PID ) at 20 , 30 , and 50 min after drug administration , and was significantly more effective than butylscopolamine at 30 and 50 min for the secondary efficacy endpoint , pain intensity differences on a categorical scale . Dipyrone had the highest SPID0–2 h of the three drugs ( P<0.05 ) . Only 5 patients receiving dipyrone needed “ rescue ” medication as compared with 13 patients given tramadol and 11 patients receiving butylscopolamine .  Adverse events were observed in 4 patients receiving butylscopolamine and in 1 patient each given dipyrone and tramadol . “ Distinct ” pain relief as assessed on a visual analogue scale ( VAS ) is a reliable method of determining the onset of analgesic action in the colic pain model To determine the effects of indomethacin suppositories in the relief of acute colic and prevention of recurrent colic , we instituted a prospect i ve double-blind , placebo-controlled protocol . Patients were r and omized to receive either 50 mg . indomethacin or placebo suppositories every 8 hours and all patients received prescriptions for supplemental narcotics to be used on an as needed basis . Relief of colic was assessed by counting the total number of supplemental narcotics used by each patient per 24 hours during the study period , which was defined as until passage of the calculus or 5 days . There were 41 patients entered into the study protocol and complete followup was available for 26 . Mean calculus size was 3.4 mm . in the indomethacin group versus 3.1 mm . in the placebo group . All 13 patients in the control group had recurrent episodes of colic and 8 of these 13 had more than 1 recurrent episode . Five patients in the placebo group required admission to the hospital for control of pain . In contrast , only 4 of the 13 patients in the treatment group had colic and only 1 had more than 1 episode of colic . No patient in the active drug group required admission to the hospital for control of pain . Over-all the ratio of supplemental narcotic used by the placebo group versus the indomethacin group was 7.6:1 ( p less than 0.005 ) . The mean interval time to passage of the calculus was slightly lower in the indomethacin group ( 89 versus 82 hours ) but this difference was not statistically significant ( p greater than 0.10 ) . Our data strongly support the use of indomethacin suppositories in the prevention of recurrent colic secondary to ureteral calculi The effect of glucagon administered as a bolus ( 1 mg ) followed by a continuous infusion ( 2 mg/h ) for 8 h and a placebo was compared in 37 adults with urographically demonstrated ureteral calculi less than 6 mm . The bolus injection was given 20 min after start of intravenous urography , and the infusion was initiated immediately afterwards . No effect on pain relief or passage of calculi was found . Nausea and /or vomiting were recorded significantly more frequently in patients who had glucagon than in patients who had the placebo . It is concluded that glucagon is of no value in acute ureteral colic A comparative , r and omized , double-blind study of diclofenac sodium 75 mg i m versus Baralgin ( a combination drug composed of dipyrone and two spasmolytics ) 5 mL iv was performed on 57 patients with renal colic . Both groups were comparable as to age , sex , pain evolution time before treatment , and no treatment for renal colic in the six hours preceding trial drug administration . No significant differences were found between the two groups with respect to the evolution of pain after the first dose or in the frequency of administration of a second dose . Tolerability was good in both groups , but sweating and pain throughout the vein were observed in one patient in the Baralgin group . We concluded that diclofenac sodium constitutes an excellent alternative to pyrazolone analgesics , with the advantages of being monotherapy and having good tolerability , when used as intramuscular injection in ambulatory patients In an open investigation , ciramadol , a partial agonist opioid , was found to be a potent analgesic when given intravenously in patients experiencing renal colic . Single intravenous doses of 20 , 30 and 40 mg of ciramadol were given to 11 , 11 and 12 patients with renal colic , respectively , and good pain relief was obtained in 10 , 11 and 10 patients , respectively . Vomiting and nausea occurred in 9 patients , 4 in the 20 mg group , 2 in the 30 mg group and 3 in the 40 mg group . This adverse effect was related to st and ing and walking following the ciramadol injection PURPOSE To study the safety and efficacy of intranasal desmopressin and intramuscular tramadol versus pethidine for treatment of renal colic . MATERIAL S AND METHODS A total of 90 adult patients who presented with renal colic to the emergency wards were recruited in this study . The patients were r and omly assigned to receive 100 mg intramuscular tramadol , 40µ g intranasal desmopressin , or 40µ g intranasal desmopressin plus 100 mg intramuscular tramadol . The severity of the pain was assessed using Visual Analogue Scale . RESULTS The studied patients consisted of 49 men and 41 women with the mean age of 35.20 ± 13.26 years ( range , 16 to 82 years ) . There was no statistically significant difference regarding the mean age ( F [ 2 
    Output:
    
Although due to variability in studies ( inclusion criteria , outcome variables and interventions ) and the evidence is not of highest quality , we still believe that NSAIDs are an effective treatment for renal colic when compared to placebo or antispasmodics .
The addition of antispasmodics to NSAIDS does not result in better pain control .
Major adverse effects are not reported in the literature for the use of NSAIDs for treatment of renal colic