5. Lidocaine for Renal Colic Pain Control

Take Home: Lidocaine IV seems like a reasonable, “non-opiate” alternative therapy for patients with reasons to not want to provide opiates.  (high opiate tolerance, pregnancy (category B), or suspected abuse). It is just one study, but an interesting alternative I will use.

Effectiveness of intravenous lidocaine versus intravenous morphine for patients with renal colic in the emergency department

–  BMC Urology 2012

Click to access 1471-2490-12-13.pdf

Design: Prospective Randomized Double Blind trial

Population: Healthy 18-65 year olds who presented to the ED with clinical renal colic

  • EKG obtained and normal
  • No history of heart disease

Intervention/Control: Randomized to EITHER:

  1. Lidocaine 1.5mg/kg IV (slow IV push)
  2. Morphine 0.1 mg/kg IV (slow IV push)

Primary Outcome: VAS Pain score was measured at Time 0,5,10,15, and 30

Secondary Outcomes: Side Effects of medications

Results: 240 patients were randomized.

Lidocaine is group I, Morphine is group II

  • 90% of patients responded to Lidocaine vs 70% in Morphine group. 


Is the difference between 1.13 and 2.23 really clinically significant – unsure, BUT the data suggests it is at least as effective at pain reduction as morphine.

Side Effects:

June 5

Conclusion: Lidocaine is a safe and effective therapy for Renal Colic in patients without heart disease.

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