title: Painless ESWL by cutaneous application of vaseline.
abstract: In a prospective study we investigated the efficacy of cutaneous vaseline application in pain reduction during ESWL. In 150 patients (group 1) vaseline was applied on a skin area of 10 x 20 cm corresponding to the entry site of shock waves directly before ESWL was started. In 75 patients (group 2) ESWL was performed without vaseline. 10/150 (6.7%) in group 1 and 27/75 (36.4%) in group 2 (p < 0.001) needed additional analgesic sedation. Requirement for supplementary analgosedation was most pronounced for patients with lower calyceal and distal ureteral stones [20% and 19% in group 1; 53% and 78% in group 2 (p < 0.03)]. The median pain score in group 1 was 2.5 +/- 1.05, in group 2 4.25 +/- 1.13 (p < 0.05). Local vaseline application significantly reduced pain during ESWL independent from stone location. Because of its high viscosity vaseline inhibited the development of cavitation bubbles at the skin surface. Cutaneous vaseline application reducing the need for analgesic sedation might especially be useful in outpatient ESWL procedures.
authors.affiliation: Department of Urology, University of Cologne, Köln, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Heidenreich
authors.forename: R
authors.initials: R
authors.lastname: Bonfig
authors.forename: D M
authors.initials: DM
authors.lastname: Wilbert
authors.forename: U H
authors.initials: UH
authors.lastname: Engelmann
mesh_terms: D000287:Administration, Topical; D016292:Procedural Sedation; D004643:Emollients / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D007669:Kidney Calculi / Q000628:therapy*; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D010147:Pain Measurement; D010577:Petrolatum / Q000008:administration & dosage*; D011446:Prospective Studies; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000628:therapy*; D014783:Viscosity
chemical_list: D004643:Emollients; D010577:Petrolatum