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


METHODS
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.


RESULTS
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).


CONCLUSIONS
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.
Lutfi Kirdar Training and Research Hospital 1, Urology Clinics, Istanbul, Turkey. bilaleryildirim@yahoo.com
Bilal
B
Eryildirim
Uğur
U
Kuyumcuoğlu
Fatih
F
Tarhan
Gökhan
G
Faydaci
Fatih
F
Uruç
D000328:Adult; D000698:Analgesia / Q000379:methods*; D019162:Anesthetics, Combined / Q000627:therapeutic use*; D000779:Anesthetics, Local / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D004008:Diclofenac / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000628:therapy*; D008012:Lidocaine / Q000627:therapeutic use*; D000077442:Lidocaine, Prilocaine Drug Combination; D008096:Lithotripsy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D010147:Pain Measurement; D011318:Prilocaine / Q000627:therapeutic use*; D011446:Prospective Studies; D016896:Treatment Outcome
D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000077442:Lidocaine, Prilocaine Drug Combination; D011318:Prilocaine; D004008:Diclofenac; D008012:Lidocaine