392 Sterile Water Injections for Acute Pain Relief in Renal Colic: A Meta-Analysis of Randomised Controlled Trials

Perros, I; Swift, C; Mallen, C; Sokhal, B S; Kitchen, M

Abstract

Aim
Effective renal colic management relies on optimal pain relief. Each medication has its distinct side effects and contraindications. Sterile water injections (SWIs) have emerged as a potential alternative to standard treatment. This systematic review and meta-analysis of randomised controlled trials (RCTs) aimed to evaluate the effectiveness of SWIs analgesia in renal colic.

Method
This study was conducted in accordance with the Preferred Reporting items for Systematic Reviews and Meta-Analyses. MEDLINE, CINALH, Web of Science and Cochrane were searched to identify RCTs comparing SWIs with placebo or other analgesics in renal colic patients. Data were pooled and analysed using random-effects modelling with 95% confidence intervals (CIs).

Results
Six RCTs including 1,322 renal colic patients were included, with 466 (35.2%) receiving SWIs. Patients receiving SWIs had comparable demographics and presenting features to the control groups, with control medications ranging from placebos, non-steroidal anti-inflammatories, and opioids. Self-reported pain scores at 30 minutes following intervention were lower in SWI than placebo (MD=-4.63, 95% CI:-5.16, -4.10, P < 0.00001) and other analgesics (MD = -0.36, 95% CI: -0.52, -0.21, P < 0.00001). The use of rescue analgesia was lower in those receiving SWIs compared to placebo (OR = 0.24, 95% CI: 0.10, 0.59, P = 0.002) and other analgesics (OR = 0.46, 95% CI: 0.29, 0.74, P = 0.001). No significant side effects were attributed to SWI use.

Conclusions
SWIs demonstrated superior pain relief and reduced rescue analgesia requirements, compared to placebo and standard treatment, offering a promising alternative for patients where traditional options are unsuitable.

Citation

Perros, I., Swift, C., Mallen, C., Sokhal, B. S., & Kitchen, M. (2025, March). 392 Sterile Water Injections for Acute Pain Relief in Renal Colic: A Meta-Analysis of Randomised Controlled Trials. Poster presented at ASiT Surgical Conference, Belfast, UK

• Presentation Conference Type: Poster
• Conference Name: ASiT Surgical Conference
• Start Date: Mar 7, 2025
• End Date: Mar 9, 2025
• Acceptance Date: Jun 19, 2025
• Online Publication Date: Jun 19, 2025
• Publication Date: Jun 19, 2025
• Deposit Date: Jul 9, 2025
• Journal: British Journal of Surgery
• Print ISSN: 0007-1323
• Electronic ISSN: 1365-2168
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 112
• Issue: Supplement_10
• DOI: https://doi.org/10.1093/bjs/znaf128.717
• Public URL: https://keele-repository.worktribe.com/output/1320983
• Publisher URL: https://academic.oup.com/bjs/article/112/Supplement_10/znaf128.717/8165125