title: Pain control using pethidine in combination with diazepam compared to diclofenac in combination with hyoscine-n-butyl bromide: in patients undergoing extracorporeal shock wave lithotripsy.
abstract: BACKGROUND
  Extracorporeal Shock Wave Lithotripsy (ESWL) remains the preferred least invasive treatment for urinary tract stones. The main purpose of this study was to compare two treatment modalities for pain control during the ESWL procedure.
  
  
  METHODS
  From 2013 to 2014, 220 patients received ESWL for kidney stones. Before the procedure, the weight and height were measured to determine the body mass index (BMI); in addition, oxygen saturation and the pulse of the patients, as well as pain level were determined. The pain control provided included two different methods: diclofenac sodium plus hyoscine-N-butyl bromide in the first group and pethidine plus diazepam in the second group. The pain level of the patients was determined using two different scales: the Wong-Baker and the Visual Analogue scales (VAS). At the end of three sessions, all patients were evaluated for the stone fragmentation rate by plain abdominal X-ray, and the findings were recorded and analyzed.
  
  
  RESULTS
  A total of 220 patients were enrolled in this study. There were 91 patients in the first group (diclofenac sodium + hyoscine-N-butyl bromide) (male/female: 63/28) and 129 (male/female: 83/46) patients in the second group (pethidine HCL +diazepam). The mean age with SD according to each group was 42.03 (±16.43) and 42.56 (±14.23), respectively (p = 0.8). With regard to pain scores (using the Wong-Baker and VAS scales), the responses were significantly lower in the second group (p <0.001).
  
  
  CONCLUSIONS
  Pethidine in combination with diazepam was superior to diclofenac and Hyoscine-N-butyl bromide for pain in patients undergoing ESWL.
authors.affiliation: Kafkas University, Medical School, Department of Urology, Kars, Turkey.
authors.forename: Aslan
authors.initials: A
authors.lastname: Demir
authors.affiliation: Kafkas University, Medical School, Department of Urology, Kars, Turkey.
authors.forename: Kursat
authors.initials: K
authors.lastname: Cecen
authors.affiliation: Kafkas University, Medical School, Department of Urology, Kars, Turkey.
authors.forename: Mert Ali
authors.initials: MA
authors.lastname: Karadag
authors.affiliation: Kafkas University, Medical School, Department of Urology, Kars, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Uslu
authors.affiliation: Kafkas University, Medical School, Department of Urology, Kars, Turkey.
authors.forename: Omer Erkam
authors.initials: OE
authors.lastname: Arslan
keywords: analgesia; extracorporeal shock wave lithotripsy; sedation