title: The opioid-sparing effect of diclofenac sodium in outpatient extracorporeal shock wave lithotripsy (ESWL).
abstract: OBJECTIVE
  To evaluate the opioid-sparing and analgesic effect of diclofenac sodium in ambulatory nonimmersion extracorporeal shock wave lithotripsy (ESWL).
  
  
  METHODS
  Randomized, double-blind, placebo-controlled study.
  
  
  METHODS
  Large referral hospital.
  
  
  METHODS
  Twenty-seven ASA physical status I and II patients with upper renal tract nephrolithiasis.
  
  
  METHODS
  ESWL was performed with a sedative-analgesic technique. Diclofenac sodium 75 mg or an equal volume of saline was given intramuscularly 45 minutes prior to the procedure. Fentanyl and midazolam were added to maintain adequate sedation and analgesia.
  
  
  RESULTS
  Demographically, both groups were comparable. In the diclofenac sodium group, heart rate was slightly higher, treatment time was shorter, more shock waves were administered (p < 0.02), and less fentanyl was required (p < 0.02). Mean arterial pressure was lower and arterial oxygen saturation by pulse oximeter was higher in the diclofenac sodium group. There were no differences between the groups in voltage, stone size, fragmentation, dose of midazolam administered, or overall assessment by both the doctors and patients.
  
  
  CONCLUSIONS
  Patients administered diclofenac sodium received a greater number of shock waves, required less fentanyl, and showed a marginal improvement in hemodynamic stability and oxygenation during ambulatory nonimmersion ESWL.
authors.affiliation: Department of Anesthesiology and Intensive Care, Meir Hospital, Kfar Sava, Israel.
authors.forename: B
authors.initials: B
authors.lastname: Fredman
authors.forename: R
authors.initials: R
authors.lastname: Jedeikin
authors.forename: D
authors.initials: D
authors.lastname: Olsfanger
authors.forename: M
authors.initials: M
authors.lastname: Aronheim
mesh_terms: D000328:Adult; D000698:Analgesia; D000701:Analgesics, Opioid; D000771:Anesthesia, Intravenous; D001794:Blood Pressure / Q000187:drug effects; D004008:Diclofenac / Q000008:administration & dosage / Q000494:pharmacology; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000494:pharmacology; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006993:Hypnotics and Sedatives; D007669:Kidney Calculi / Q000628:therapy; D008096:Lithotripsy / Q000379:methods; D008297:Male; D008874:Midazolam / Q000008:administration & dosage / Q000494:pharmacology; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D010919:Placebos
chemical_list: D000701:Analgesics, Opioid; D006993:Hypnotics and Sedatives; D010919:Placebos; D004008:Diclofenac; D008874:Midazolam; D010100:Oxygen; D005283:Fentanyl