ESWL: Comparing two analgesic techniques. Our experience.
OBJECTIVE
We compared the effects of intramuscular analgesia versus intramuscular analgesia associated with topical application of Luan (gel containing lidocaine 1%) on the efficacy of extracorporeal shockwave lithotripsy (ESWL).


METHODS
From January 2001 to November 2002, 300 patients (mean age 46) were treated for kidney or upper ureteral radiopaque stones with ESWL, using a Dornier Compact Delta magneto lithotripter. The patients were divided into two groups: group A, 180 patients, received intramuscular analgesia with Ketorolac 30 mg, Tramadolo 100 mg and, during treatment, intravenous betametasone 4 mg. Group B, 120 patients, received the same pharmacological treatment associated with topical application of Luan.


RESULTS
At 3 months, the stone-free rate in group A was 61% compared with 79% in group B. The energy of treatment was less than 13 kV in group A and less than 15 kV in group B.


CONCLUSIONS
For ESWL treatment of kidney stones of 20 mm or less and ureteral stones of 15 mm or less, we suggest local analgesia with topical Luan and intramuscular analgesia. This approach increases the success rate of ESWL and reduces the discomfort associated with treatment.
Saita
A
A
University of Catania, Clinica Urologica II, Catania, Italy.
Bonaccorsi
A
A
Aquilino
M
M
Guzzardi
F
F
Lazzara
A
A
Motta
M
M
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000698:Analgesia / Q000379:methods; D001623:Betamethasone / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D020910:Ketorolac / Q000008:administration & dosage*; D020911:Ketorolac Tromethamine / Q000008:administration & dosage*; D007669:Kidney Calculi / Q000000981:diagnostic imaging / Q000628:therapy; D008012:Lidocaine / Q000008:administration & dosage*; D008096:Lithotripsy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011318:Prilocaine / Q000008:administration & dosage*; D011446:Prospective Studies; D011859:Radiography; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000000981:diagnostic imaging / Q000628:therapy
D011318:Prilocaine; D020911:Ketorolac Tromethamine; D001623:Betamethasone; D008012:Lidocaine; D020910:Ketorolac