In patients with renal colic, intravenous ketorolac at 10, 20, and 30 mg doses exhibit comparable analgesic efficacy. 

This randomized, noninferiority, double-blind, prospective clinical trial examined the efficacy (pain-relieving effects) of three doses (10, 20, and 30 mg) of ketorolac in individuals having renal colic.

The study enrolled 165 adult patients presenting to the emergency department with renal colic and were randomized to 10, 20, and 30 mg of intravenous ketorolac (55 participants in each group). Recording of the pain was done every fifteen minutes from the baseline up to sixty minutes. The major endpoint was pain decline at 30 minutes. If the participants still needed additional analgesics at thirty minutes, 0.1 mg/kg morphine sulfate was intravenously administered as a rescue analgesic agent.

The median visual analog scale (VAS) score in 30 minutes was found to improve from 90 mm at baseline to 40 mm in participants receiving 30-mg ketorolac. The improvement was 50 mm and 40 mm in the 10- and 20-mg ketorolac groups, respectively, with no profound differences between the groups.  In comparison with the baseline pain scores, all the groups displayed substantial responses in terms of pain control, as shown in Figure 1:

The secondary endpoints showed comparable rescue analgesic administration and side effects. No severe adverse events were reported.              

Administration of 10 mg ketorolac was comparable to higher doses of 20 and 30 mg for alleviating  renal stone pain. Thus, a lower dose of 10 mg ketorolac is sufficient for the management of renal colic.