Published online Oct 27, 2016. doi: 10.4240/wjgs.v8.i10.713
Peer-review started: May 23, 2016
First decision: July 4, 2016
Revised: August 20, 2016
Accepted: September 7, 2016
Article in press: September 8, 2016
Published online: October 27, 2016
To review the evidence for the use of different non-steroidal anti-inflammatory drugs (NSAIDs) in the treatment of biliary colic.
The strategies employed included an extensive literature review for articles and studies related to biliary colic from electronic databases including PubMed, Science Direct, Wiley Inter Science, Medline and Cochrane from last 15 years. Keywords: “Biliary colic”, “management of biliary colic”, “non-steroidal anti-inflammatory drugs”, “cholelithiasis” and “biliary colic management”. Six randomized control trials, 1 non-randomized trial and 1 meta-analysis were included in this review. The outcomes of these studies and their significance have been reviewed in this paper.
Current evidence suggests there are no set protocols for biliary colic pain management. NSAIDs are potent in the management of biliary colic, not only in terms of symptom control but in disease progression as well. Apart from the studies on diclofenac and ketorolac, there are studies which have shown that intravenous tenoxicam and injectable flurbiprofen are equally effective in managing biliary colic. The efficacy of NSAIDs is superior in terms of lower number of doses and longer duration of action in comparison to other analgesic agents.
This literature review has found that NSAIDs are safe and effective for pain control in biliary colic, and reduce the likelihood of further complications.
Core tip: There are currently no set protocols for pain management in biliary colic. This literature review analyses studies from the last 15 years and shows that non-steroidal anti-inflammatory drugs (NSAIDs) provide safe and effective pain control. It also suggests that NSAIDs play an important role in reducing the complication risk following episodes of biliary colic.