Comparative study of etofenamate and fentanyl for outpatient extracorporeal shockwave lithotripsy.
OBJECTIVE
This study aimed to compare the clinical efficacy and safety of etofenamate (a non-steroidal anti-inflammatory drug) and fentanyl (an opioid analgesic) for outpatient extracorporeal shock wave lithotripsy (ESWL).


METHODS
60 non-premedicated patients underwent ESWL for urinary tract calculus with the Multimed 2000 (ELMED Lithotripsy Co.. Turkey) lithotripter. None of patients had previous experience with ESWL treatment. The patients were divided into two groups. A single dose of 1 g etofenamate was given to the patients intramuscularly 25 min before ESWL in group I (n = 30) and 0.1 mg fentanyl was administered intravenously just before ESWL in group II (n = 30). At the end of the treatment a visual analogue score (VAS) of 0 (no pain) to 10 (greatest pain) was used to evaluate the pain. Blood pressure, heart rate and arterial oxygen tension (PaO2) were measured before and during the ESWL. Groups were compared according to the pain scores, stone size, number of shocks, maximum voltage achieved, duration of ESWL and incidence of side-effects of the administered drug. Data were analysed with the Mann-Whitney U-test.


RESULTS
No statistical differences were found between the two groups regarding achieved maximal energy levels, pain scores and number of shock waves given (p < 0.01). Satisfactory stone fragmentation was achieved in both groups. There were no changes in blood pressure or heart rate during the ESWL in either group. PaO2 was not affected in the etofenamate group, whereas a transient desaturation in two patients and giddiness in three patients were recorded in the fentanyl group.


CONCLUSIONS
Both etofenamate and fentanyl have clinically sufficient effects on pain, and can be used safely for outpatient ESWL procedures.
Unsal
A
A
Department of Urology, School of Medicine, Fatih University, Ankara, Turkey. unsalali@hotmail.com
Cimentepe
E
E
Bozoklu
A
A
Sağlam
R
R
D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D005260:Female; D005283:Fentanyl / Q000627:therapeutic use*; D005439:Flufenamic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D006801:Humans; D008096:Lithotripsy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000517:prevention & control*
D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D005439:Flufenamic Acid; C015207:etofenamate; D005283:Fentanyl