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Analgesia For Shock Wave Lithotripsy

2002; Lippincott Williams & Wilkins; Volume: 167; Issue: 4 Linguagem: Inglês

10.1016/s0022-5347(05)65164-6

1527-3792

John Parkin, Francis X. Keeley, Anthony G. Timoney,

Urinary Bladder and Prostate Research

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Apr 2002Analgesia For Shock Wave Lithotripsy John Parkin, Francis X. Keeley, and Anthony G. Timoney John ParkinJohn Parkin More articles by this author , Francis X. KeeleyFrancis X. Keeley More articles by this author , and Anthony G. TimoneyAnthony G. Timoney More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)65164-6AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluated the effectiveness of and patient preference for analgesia used during shock wave lithotripsy by comparing diclofenac alone with a combination of diclofenac and patient controlled analgesia, that is alfentanil. Materials and Methods: A total of 64 patients were treated using a Lithotriptor S (Dornier Medical Systems, Marietta, Georgia) and randomized to receive diclofenac alone or combined with an alfentanil patient controlled analgesia pump. If treated twice, they crossed over to the alternative form of analgesia. A record was maintained of the site and size of the stone, maximum power achieved, number of shocks, amount of alfentanil used and need for additional analgesia. After treatment patients scored on a visual analog scale the maximum level of pain and satisfaction with analgesia. Results: There was no difference in the mean size of the stone treated (8.6 and 7.5 mm.), energy level (71% and 71% or approximately 17 kV.) or number of shocks (3,000 and 2,900, respectively) in the groups. Only 2 patients in the diclofenac group required additional analgesia and there were no significant side effects from either treatment. The mean pain scores were not significantly different in the diclofenac and patient controlled analgesia groups (3.54 and 2.93, respectively, (p = 0.34), although those on patient controlled analgesia were more satisfied (7.72 versus 9.14, p = 0.04). Of the 38 patients who presented twice 58% preferred diclofenac alone. Conclusions: This study suggests that there is no significant difference in the level of pain experienced with diclofenac alone or when combined with an alfentanil patient controlled analgesia pump during shock wave lithotripsy. However, patients are more satisfied with treatment when a patient controlled analgesia pump is available. References 1 : First clinical experience with extracorporeal induced destruction of kidney stones by shock waves. J Urol1982; 127: 417. Abstract, Google Scholar 2 : Report of the United States Cooperative Study of extracorporeal shock wave lithotripsy. J Urol1986; 135: 1127. 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Google Scholar 15 : Use of patient-controlled analgesia for management of acute pain. JAMA1988; 259: 243. Google Scholar From the Bristol Urological Institute, Southmead Hospital, Bristol, United Kingdom© 2002 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byMora B, Iannuzzi M, Lang T, Steinlechner B, Barker R, Dobrovits M, Wimmer C and Kober A (2018) Auricular Acupressure as a Treatment for Anxiety Before Extracorporeal Shock Wave Lithotripsy in the ElderlyJournal of Urology, VOL. 178, NO. 1, (160-164), Online publication date: 1-Jul-2007. Volume 167Issue 4April 2002Page: 1613-1615 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.Keywordslithotripsydiclofenacpatient-controlledanalgesiacalculiurinary tractMetricsAuthor Information John Parkin More articles by this author Francis X. Keeley More articles by this author Anthony G. Timoney More articles by this author Expand All Advertisement PDF downloadLoading ...