Intravenous paracetamol versus oral tramadol for pain control during shockwave lithotripsy: a prospective randomized comparative study

Year 2016, Volume: 11 Issue: 1, 14 - 21, 01.01.2016

Saadettin Yilmaz Hakan Erbay Sadik Fidan Omer Levent Tuncay Deniz Bolat

Abstract

Objectives: Shock wave lithotripsy SWL is a simple, effective, and minimally invazive treatment option for urinary tract stone disease. Nevertheless, pain during the SWL procedure is one of the most common restriction factor for this treatment modality.We aimed to compare the efficacy and adverse effects of intravenous IV paracetamol and oral tablet tramadol for pain control during SWL procedure. Material and Methods: We enrolled 54 patients with the indication of SWL therapy in this prospective randomized comparative study. 1 g IV paracetamol infusion was applied to group I n:28 and 100 mg oral tramadol was applied to group II n:26 . The pain was measured by 10-point visual analog scale VAS . 1 mg/kg of body weight intramuscular pethidine meperidine was applied when supplemental analgesia required. Results: The mean VAS score was significantly lower in group I patients than in group II at 5, 10, 15, 30, 40th minutes during lithotripsy P=0.011, P=0.009, P=0.001, P=0.000, P=0.000, respectively . Supplementary analgesic requirement was higher in group I than group II which received more shockwaves or higher voltages. However, this difference was not statistically significant P=0.199 . Conclusions: This is the first study comparing the analgesic effects of IV paracetamol and oral tramadol for pain control during SWL in the literature. IV paracetamol provides better analgesia than oral tramadol with minimal side effects. However, a minimal increase in supplemental analgesia requirement should be considered in patients who will receive more shockwaves or higher voltages

Keywords

Analgesia , extracorporal shockwave lithotripsy , paracetamol , tramadol , pain

Şok dalga litotripsi sırasındaki ağrı kontrolünde intravenöz parasetamole karşın oral tramadol: prospektif, randomize, karşılaştırmalı çalışma

Abstract

Amaç: Şok dalga litotripsi SWL üriner sistem taş hastalığının tedavisinde kolay, etkili ve minimal invaziv bir tedavi seçeneğidir. Bununla beraber, SWL işlemi sırasında hastanın duyduğu ağrı bu tedavi seçeneğini kısıtlayan en önemli faktördür. SWL işlemi sırasındaki ağrının kontrolü için intravenöz IV parasetamol ile oral tablet tramadolün etkinliğini ve yan etkilerini karşılaştırdık. Gereç ve Yöntemler: Bu prospektif randomize karşılaştırmalı çalışmaya SWL tedavisi endikasyonu olan 54 hasta dahil edildi. Grup I n:28 ’ deki hastalara 1 g IV parasetamol infüzyonu uygulanırken grup II n:26 ’ deki hastalara 100 mg oral tramadol verildi. Ağrı düzeyi 10’luk vizüel analog skala VAS ile ölçüldü. Ek analjezi gereksinimi olduğunda 1 mg/kg dozunda intramüsküler petidin meperidin uygulandı. Bulgular: Litotripsi işlemi sırasında 5, 10, 15, 30 ve 40. Dakikalardaki ortalama VAS skorları grup I’deki hastalarda grup II’deki hastalara kıyasla anlamlı olarak daha düşüktü sırasıyla, P=0.011, P=0.009, P=0.001, P=0.000, P=0.000 . Ek analjezik gereksinimi, daha fazla şok dalgasına ve voltaja maruz kalan grup I’deki hastalarda grup II’dekilerden daha fazlaydı. Fakat bu fark istatistiksel olarak anlamlı değildi P=0.199 . Sonuç: Bu çalışma SWL işlemi sırasında IV parasetamol ile oral tramadolün analjezik etkinliğini karşılaştıran literatürdeki ilk araştırmadır. IV parasetamol, minimal yan etki ile oral tramadolden daha iyi analjezik etkinlik göstermektedir. Bununla birlikte daha fazla şok dalgası ve daha yüksek voltaj uygulanacak hastalarda az da olsa ek analjezik ihtiyacı olabileceği göz önünde bulundurulmalıdır

Keywords

Analjezi , vücut dışı şok dalga litotripsi , parasetamol , tramadol , ağrı

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