Does Combined Epidural Lignocaine and Fentanyl Provide Better Anaesthesia for ESWL than Lignocaine Alone?

Cook, Richard J.; R, Neerhut; Dg, Thomas

doi:10.1177/0310057x9101900308

Cited by 7 publications

(3 citation statements)

References 22 publications

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“…We therefore believe that patients receiving epidural fentanyl should be under surveillance in the early postoperative period. All cases of respiratory depression have been observed after 100 pg (49, 50) or 1.25 pg/kg (44) fentanyl. This suggests that bolus doses of 50-75 pg might be safer than 100 pg and still produce clinically relevant reduction in the incidence of pain (Table 7).…”

Section: Discussionmentioning

confidence: 99%

“…In all trials the anaesthetic solution was injected at L2-3 or L34, with the exception of one study (44), in which the site of puncture was not specified. In 4 studies patients were sedated during surgery with midazolam (44,45), fentanyl-benzodiazepines (46) and papaveretum (43), respectively. However, in several papers it was not explicitly stated that sedation was not administered.…”

Section: Characteristics Of Selected Trialsmentioning

confidence: 99%

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Epidural fentanyl, adrenaline and clonidine as adjuvants to local anaesthetics for surgical analgesia: meta‐analyses of analgesia and side‐effects

Curatolo

Petersen-Felix

Scaramozzino

et al. 1998

Acta Anaesthesiol Scand

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The analysis of current literature shows that the addition of fentanyl to local anaesthetics for intraoperative epidural analgesia is safe and advantageous. The reduction in the incidence of pain during surgery is quantitatively high and therefore clinically significant. Side-effects are mild. Randomized, controlled trials have to be performed in order to clarify the role of adrenaline and clonidine as epidural adjuvants for surgical analgesia.

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Section: Discussionmentioning

confidence: 99%

Section: Characteristics Of Selected Trialsmentioning

confidence: 99%

Epidural fentanyl, adrenaline and clonidine as adjuvants to local anaesthetics for surgical analgesia: meta‐analyses of analgesia and side‐effects

Curatolo

Petersen-Felix

Scaramozzino

et al. 1998

Acta Anaesthesiol Scand

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“…Four studies were excluded as they did not meet our inclusion criteria (epidural analgesia (14), intrathecal Sufentanil (34), accupuncutre (17, 35). Seven studies were excluded due to crossover between experimental and control arms (21, 36-40).…”

Section: Excluded Studiesmentioning

confidence: 99%

Analgesia for patients undergoing shockwave lithotripsy for urinary stones – a systematic review and meta-analysis

et al. 2017

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Background Shock wave lithotripsy (SWL) is the first line treatment modality for a significant proportion of patients with upper urinary tracts stones. Simple analgesics, opioids and non-steroidal anti-inflammatory drugs (NSAIDs) are all suitable agents but the relative efficacy and tolerability of these agents is uncertain.Objectives To determine the efficacy of the different types of analgesics used for the control of pain during SWL for urinary stones.Materials and Methods We searched the Cochrane Renal Group’s Specialised Register, MEDLINE, EMBASE and also hand-searched reference lists of relevant articles (Figure-1). Randomised controlled trials (RCT’s) comparing the use of any opioid, simple analgesic or NSAID during SWL were included. These were compared with themselves, each-other or placebo. We included any route or form of administration (bolus, PCA). We excluded agents that were used for their sedative qualities. Data were extracted and assessed for quality independently by three reviewers. Meta-analyses have been performed where possible. When not possible, descriptive analyses of variables were performed. Dichotomous outcomes are reported as relative risk (RR) and measurements on continuous scales are reported as weighted mean differences (WMD) with 95% confidence intervals.Results Overall, we included 9 RCTs (539 participants from 6 countries). Trial agents included 7 types of NSAIDs, 1 simple analgesic and 4 types of opioids. There were no significant differences in clinical efficacy or tolerability between a simple analgesic (paracetamol) and an NSAID (lornoxicam). When comparing the same simple analgesic with an opioid (tramadol), both agents provided safe and effective analgesia for the purpose of SWL with no significant differences. There were no significant differences in pain scores between NSAIDs or opioids in three studies. Adequate analgesia could be achieved more often for opioids than for NSAIDs (RR 0.358; 95% CI 043 to 0.77, P=0.0002) but consumed doses of rescue analgesia were similar between NSAIDs and opioids in two studies (P=0.58, >0.05). In terms of tolerability, there is no difference in post-operative nausea and vomiting (PONV) between the groups (RR 0.72, 95% CI 0.24 to 2.17, P=0.55). One study compared outcomes between two types of NSAIDs (diclofenac versus dexketoprofen). There were no significant differences in any of our pre-defined outcomes measures.Conclusion Simple analgesics, NSAIDs and opioids can all reduce the pain associated with shock wave lithotripsy to a level where the procedure is tolerated. Whilst there are no compelling differences in safety or efficacy of simple analgesics and NSAIDs, analgesia is described as adequate more often for opioids than NSAIDs.

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Analgesia for patients undergoing shockwave lithotripsy for urinary stones

Aboumarzouk

Tait

Beatty

et al. 2012

Cochrane Database of Systematic Reviews

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Does Combined Epidural Lignocaine and Fentanyl Provide Better Anaesthesia for ESWL than Lignocaine Alone?

Cited by 7 publications

References 22 publications

Epidural fentanyl, adrenaline and clonidine as adjuvants to local anaesthetics for surgical analgesia: meta‐analyses of analgesia and side‐effects

Epidural fentanyl, adrenaline and clonidine as adjuvants to local anaesthetics for surgical analgesia: meta‐analyses of analgesia and side‐effects

Analgesia for patients undergoing shockwave lithotripsy for urinary stones – a systematic review and meta-analysis

Analgesia for patients undergoing shockwave lithotripsy for urinary stones

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