Renal colic caused by nephrolithiasis is common in urological and emergency clinical practice. Timely pain management is an essential component of renal colic treatment at the time of the patient visit. Given the adverse side effects of nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids, the development of new mechanism-based analgesics with fewer side effects and better pain relief properties appeared crucial. Thus, we conduct a meta-analysis of randomized controlled trials (RCTs) to systematically assess the efficacy and safety of ketamine versus opioids in the treatment of patients with renal colic for the first time. To the best of our knowledge, no previous studies have been conducted on this subject matter.

Compared to opioids, the use of ketamine produces more persistent relief in patients with renal colic and has a much better safety profile. Our meta-analysis concluded that ketamine holds promise as an alternative to opioids for renal colic patients in pain management in the emergency department.