Antispasmodic and analgesic strategies for renal colic in pregnancy: a comprehensive analysis
5 affiliations
- 1Guizhou University of Traditional Chinese Medicine , ,
- 2School of Basic Medical Science of Guangzhou University of Chinese Medicine , ,
- 3Guangdong Provincial Second Hospital of Traditional Chinese Medicine, Guangdong Provincial Engineering Technology Research Institute of Traditional Chinese Medicine, The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangdong Provincial Key Laboratory of Research and Development in Traditional Chinese Medicine , ,
- 4Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine , ,
- 5Emergency Department of Guangdong Provincial Hospital of Traditional Chinese Medicine , ,
Abstract
Background: Analgesia remains the paramount priority in the clinical management of gestational renal colic, yet established protocols are frequently constrained by contraindications. While antispasmodic intervention emerges as a viable alternative, the definitive pharmacological choice remains elusive. Here, we evaluated the effectiveness and safety of commonly used antispasmodic and analgesic strategies for pregnancy-related renal colic using network and pairwise meta-analyses.
Method: A literature review was undertaken utilizing three English-language databases and four Chinese-language databases, encompassing publications up to 1 January 2025. Randomized controlled trials (RCTs) that satisfied the inclusion criteria were selected for analysis. The Cochrane Risk-of-Bias Tool was employed to evaluate the risk of bias. Statistical analyses were performed, encompassing intervention comparison and ranking, assessment of consistency and heterogeneity, evaluation of publication bias, as well as meta-regression, subgroup, and sensitivity analyses.
Results: The study included ten RCTs with 936 patients. Four dimensions for the RCTs had a low risk of bias, with one dimension having “some concerns.” In network meta-analyses, phloroglucinol was most effective in relieving pain within 1 h, followed by progesterone, while anisodamine was least effective. Phloroglucinol caused the least side effects like nausea and dizziness compared to progesterone and anisodamine. In pairwise meta-analyses, phloroglucinol had a lower 6-h pain recurrence rate and fewer side effects like blurred vision and palpitations than anisodamine. Variations in phloroglucinol dosage contributed to heterogeneity, but subgroup and sensitivity analyses confirmed result stability.
Conclusion: Phloroglucinol is the preferred treatment for renal colic pain during pregnancy due to its efficacy and safety. It can be combined with progesterone, but anisodamine is not advised. Further high-quality research is necessary to confirm this finding.
Clinical Trial Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42022377502 .
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BibTeX
@article{lv2026antispasmodic,
title = {{Antispasmodic and analgesic strategies for renal colic in pregnancy: a comprehensive analysis}},
author = {Bo Lv and Yan Chen and Peiying Huang and Man Liu and Li Chen},
journal = {Frontiers in pharmacology},
year = {2026},
month = oct,
doi = {10.3389/fphar.2026.1758430},
url = {https://europepmc.org/article/PMC/PMC13668051},
note = {CC BY},
}
RIS
TY - JOUR
TI - Antispasmodic and analgesic strategies for renal colic in pregnancy: a comprehensive analysis
AU - Bo Lv
AU - Yan Chen
AU - Peiying Huang
AU - Man Liu
AU - Li Chen
PY - 2026
DA - 2026/10/01
JO - Frontiers in pharmacology
DO - 10.3389/fphar.2026.1758430
UR - https://europepmc.org/article/PMC/PMC13668051
AB - Background: Analgesia remains the paramount priority in the clinical management of gestational renal colic, yet established protocols are frequently constrained by contraindications. While antispasmodic intervention emerges as a viable alternative, the definitive pharmacological choice remains elusive. Here, we evaluated the effectiveness and safety of commonly used antispasmodic and analgesic strategies for pregnancy-related renal colic using network and pairwise meta-analyses. Method: A literature review was undertaken utilizing three English-language databases and four Chinese-language databases, encompassing publications up to 1 January 2025. Randomized controlled trials (RCTs) that satisfied the inclusion criteria were selected for analysis. The Cochrane Risk-of-Bias Tool was employed to evaluate the risk of bias. Statistical analyses were performed, encompassing intervention comparison and ranking, assessment of consistency and heterogeneity, evaluation of publication bias, as well as meta-regression, subgroup, and sensitivity analyses. Results: The study included ten RCTs with 936 patients. Four dimensions for the RCTs had a low risk of bias, with one dimension having “some concerns.” In network meta-analyses, phloroglucinol was most effective in relieving pain within 1 h, followed by progesterone, while anisodamine was least effective. Phloroglucinol caused the least side effects like nausea and dizziness compared to progesterone and anisodamine. In pairwise meta-analyses, phloroglucinol had a lower 6-h pain recurrence rate and fewer side effects like blurred vision and palpitations than anisodamine. Variations in phloroglucinol dosage contributed to heterogeneity, but subgroup and sensitivity analyses confirmed result stability. Conclusion: Phloroglucinol is the preferred treatment for renal colic pain during pregnancy due to its efficacy and safety. It can be combined with progesterone, but anisodamine is not advised. Further high-quality research is necessary to confirm this finding. Clinical Trial Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42022377502 .
SN - 1663-9812
ER -