Conclusions

In this randomized controlled study, no statistically significant difference was observed between IV lidocaine and IV ketorolac in the management of acute pain in adult patients presenting to the ED with suspected renal colic. Both medications were well tolerated, with only mild, self-limiting adverse events reported. These findings suggest that IV lidocaine may represent a potential non-opioid analgesic alternative, particularly for patients in whom NSAIDs are contraindicated or poorly tolerated. However, given the study's methodological limitations, including the absence of a formal a priori sample size calculation and the lack of imaging confirmation in all participants, these findings should be interpreted with caution. Larger, adequately powered multicenter randomized controlled trials are required to confirm the efficacy and safety of IV lidocaine in this setting.