Ozkan F et al, 2012: Comparison of Three Different Analgesic Protocols During Shockwave Lithotripsy
Ozkan F, Erdemir F, Erkorkmaz U, Kaya Z, Senayli Y, Parlaktas BS
1 Department of Anesthesiology, Gaziosmanpasa University , Tokat, Turkey
Abstract Background and Purpose: Shockwave lithotripsy (SWL) is one of the most important treatment modalities for urinary stone disease. The procedure may cause pain, and patient relaxation and cooperation are crucial in maintaining stone localization for optimal fragmentation and patient comfort during the procedure. As yet, there is not a standard analgesic protocol for patients undergoing SWL. We aimed to use three different analgesic agents and compare their efficacy during SWL in this study. Patients and Methods: Written informed consents were obtained from 95 patients with kidney stones, and they were randomized to receive lornoxicam (group L, n=32 patients), paracetamol (group P, n=31 patients), and tramadol with a patient-controlled analgesia device (group T, n=32 patients). All groups received patient-controlled analgesia with tramadol during the SWL procedure. The intensity of pain was evaluated with a visual analog scale (VAS). Results: The mean age of the patients was 41.87?16.53 years, 44.07?11.48 years, and 41.24?14.82 years in group L, group P, and group T, respectively. No significant differences were found between the three groups concerning patient age, stone location, or session duration (P>0.05). The mean VAS scores and analgesic consumption were lower in group L compared with other groups (P<0.05). Conclusion: The results of this study showed that additional administration of analgesics was decreased with intravenous lornoxicam in comparison with paracetamol and only tramadol.
J Endourol. 2012 Jun;26(6):691-6. doi: 10.1089/end.2011.0004. Epub 2011 Nov 8
PMID:22050496[PubMed - as supplied by publisher]
The authors showed in this randomized study that an intravenous dose of 8 mg of lornoxicam (an NSAID-agent) given as premedication one hour before ESWL, significantly reduced the need of additional analgesics during treatment. Although the experience of lornoxicam during ESWL is limited, this treatment appears to be an interesting alternative with the possibility of reducing the requirement of opioids and to get a better treatment tolerance by the patients.