A prospective study of Demerol vs. Toradol in the treatment of patients with
acute biliary colic
David J. Dula, M.D., Geisinger Medical Center

PaACEP 1998 Abstract

Introduction: Pain from acute biliary colic is related to distention of the
gallbladder and biliary tree. Although both Toradol and Demerol are effective
analgesics, Toradol may be superior to Demerol in treating patients with
biliary colic because it reduces inflammation and spasm in the cystic duct.
Hypothesis: Toradol is more effective than Demerol in the treatment of
patients with acute biliary colic.
Metbods: We conducted a prospective double blind study of patients presenting
to our ED with a diagnosis of acute biliary colic. Patients were randomized to
receive either 100 mg of Demerol IM or 60 mg of Toradol. Pain scores were
measured on a visual analogue scale of 1 to 10 at time 0 and at 30 minutes
after treatment. A global pain score on a scale of 0 to 3 was also used to
determine the effectiveness of treatment. The need for a rescue medication at
30 minutes for patients who had inadequate pain relief was also recorded.
Results: 30 patients were enrolled in our study, 16 in the Toradol group and
14 in the Demerol group. The average pain score at time 0 was 7.6 for the
Toradol group and 7. 3 for the Demerol group. The average pain score at time
30 minutes was 3.7 in the Toradol group and 3.4 in the Demerol group which was
not statisticaUy different ( p =.729). The mean global pain score was 1.87 for
the Toradol group and 1.78 for the Dernerol group which was not statistically
different ( p = .795).
Conclusion: In this study of patients with acute biliary colic there was no
significant difference in the pain relief achieved by using either Toradol or
Demerol. There was a trend for less rescue medication needed at 30 minutes in
the Toradol group.