Comparison of Different Analgesia Drug Regimens for Pain Control During Extracorporeal Shock Wave Lithotripsy for Renal Stones: A Randomized Control Study

Abstract

IntroductionWith the increased use of extracorporeal shock wave lithotripsy (ESWL), the management of urolithiasis has become much convenient for the patients and the health care professionals alike. However, associated with the procedure is the common complaint of pain. No agreed upon pain management strategy has yet been developed for the procedure. We compared the effect of different analgesia drug regiments for pain control.MethodologyA randomised controlled trial was carried out in Shifa International Hospital from between July 2015 to January 2016. A total of 135 patients were divided into three groups; group A received 30 g lidocaine 2% gel applied locally on corresponding lumber area 30 minutes before the procedure, group B received oral naproxen sodium 550 mg 45 minutes before the procedure, and group C received both oral naproxen and lidocaine gel. Patients were supplemented with intravenous nalbuphine during the procedure. The pain was assessed with 0-10 visual analogue scale. Both pre-procedure and post-procedure pain score was measured.ResultsAmong 135 patients, 105 (77.8%) were male and 29 (21.5%) were female with mean age of 38.7 ± 1.31 years. There was no difference of mean pain score or need for supplemental intravenous nalbuphine between groups B and C but there was significantly decreased mean pain score and need for supplemental intravenous nalbuphine in groups B and C in comparison with group A.ConclusionThe use of oral naproxen sodium with or without the addition of lidocaine gel during ESWL is a promising option for pain management during the procedure with significant improvement in comparison with lidocaine gel alone.

Extracorporeal Shock Wave Lithotripsy Success Rate and Prognostic Factors

“…Regardless of the effect of tamsulosin on analgesic use, many patients may require analgesics during the procedure. Waqas et al investigated the effect of different analgesic drug regimens on controlling the pain during the ESWL session (16). They found that the application of local 2% lignocaine gel did not affect the analgesic requirement during the ESWL procedure (16).…”

“…Waqas et al investigated the effect of different analgesic drug regimens on controlling the pain during the ESWL session (16). They found that the application of local 2% lignocaine gel did not affect the analgesic requirement during the ESWL procedure (16). According to their results, taking naproxen sodium with on-demand anesthesia could be a safe and feasible option for managing the procedural pain (16).…”

“…They found that the application of local 2% lignocaine gel did not affect the analgesic requirement during the ESWL procedure (16). According to their results, taking naproxen sodium with on-demand anesthesia could be a safe and feasible option for managing the procedural pain (16). A recent systematic review and meta-analysis revealed that both non-steroidal anti-inflammatory drugs (NSAIDs) and opioids can reduce ESWL-associated pain.…”