Comparison of three analgesic treatment protocols for pain management during extracorporeal shock wave lithotripsy

• Published in: Urologia internationalis Vol. 82; no. 3; p. 276
• Main Authors: Eryildirim, Bilal, Kuyumcuoğlu, Uğur, Tarhan, Fatih, Faydaci, Gökhan, Uruç, Fatih
• Format: Journal Article
• Language: English
• Published: Switzerland 01.01.2009
• Subjects: Adult; Analgesia - methods; Anesthetics, Combined - therapeutic use; Anesthetics, Local - therapeutic use; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Diclofenac - therapeutic use; Female; Humans; Kidney Calculi - therapy; Lidocaine - therapeutic use; Lithotripsy - adverse effects; Male; Middle Aged; Pain - etiology; Pain - prevention & control; Pain Measurement; Prilocaine - therapeutic use; Prospective Studies; Treatment Outcome
• ISSN: 1423-0399
• DOI: 10.1159/000209357

In this prospective and randomized study, we aimed to compare the efficacy of a eutectic mixture of local anesthetics (EMLA) cream, diclofenac sodium (DS) and EMLA in combination with DS (EMLA+DS) for pain management during extracorporeal shock wave lithotripsy (ESWL). 120 patients who had undergone ESWL for renal stones were included in the study. The patients were randomized into three groups: the first group was treated with a eutectic mixture of local anesthetics cream (EMLA), while intramuscular DS was applied to the second group and EMLA+DS was applied to the third group. Pain during ESWL was assessed with the 10-score linear and visual analogue pain scale and was compared between groups. Mean age was 44.4 +/- 1.9 years. There was no statistically significant difference between groups regarding patients' mean age, weight, stone size, shock waves, duration of ESWL and energy level values (p > 0.05). The mean pain score during ESWL was 3.90 +/- 0.16 in the EMLA group, 3.28 +/- 0.18 in the DS group and 3.05 +/- 0.18 in EMLA+DS group (p = 0023). DS appears to be more efficient than EMLA in reducing pain during ESWL. Using EMLA+DS has no superiority in relieving pain compared to DS-only treatment.