When kidney stone patients come into emergency rooms, complaining that the pain is worse than childbirth, or falling off a roof, doctors often have been persuaded to overtreat them with potent opioid painkillers.
"I better use the big gun" is what many doctors think, said Dr. Andrew Portis, director of the HealthEast Kidney Stone Institute in St. Paul.
Trouble is, new data suggest that another common medication works equally well, and that prescriptions of opioids create problems ranging from nausea to addiction for these patients.
HealthEast examined outcomes of kidney stone patients at its three east metro ERs over three years, and generally found better results when patients were given Toradol anti-inflammatory drugs instead of opioids.
Fewer Toradol patients needed additional medications, such as anti-nausea drugs, or admissions to the hospitals, according to results that Portis presented Friday to the American Urological Association's annual meeting in San Francisco. Toradol patients had shorter ER stays as well.
"Our tradition is big pain deserves big medications," Portis said. "More and more, we're learning that the little medications, when targeted appropriately, are actually more effective."
HealthEast has even seen a decline in surgical procedures to remove kidney stones — 75 percent of patients now try to pass stones on their own compared to 60 percent three years ago — because the non-opioid medications relieve their pain more effectively, Portis said.
Toradol works as a pain reliever, and also relaxes the muscles spasms that trap kidney stones as they try to exit the kidneys and bladder.
