The Importance of Intense Pain Management for the Treatment Success of Extracorporeal Shock Wave Lithotripsy

Öz

Aim: Shockwave lithotripsy is a painful procedure and requires adequate analgesia. This study aimed to determine the effect of effective pain management in extracorporeal shock wave lithotripsy on objective parameters such as radiation dose and operation time. Material and Method: A total of 202 patients were included in the study. The patients were divided into two groups. The first group was administered a triple analgesia combination (hyoscine N-butylbromide, metamizole, pethidine) for adequate pain control. The second group was administered diclofenac sodium alone. Results: There were 100 patients in group 1 and 102 in group 2. There was a statistically significant difference between the groups in the duration of treatment, lithotripsy period, frequency of shock waves, and radiation doses used (p<0.05). Conclusion: Effective pain management in ESWL reduces the procedure time, period, and radiation dose, thus increasing the success of the treatment.

Anahtar Kelimeler

• ESWL
• renal stone
• lithotripsy

Kaynakça

1. 1. Aboumarzouk OM, Hasan R, Tasleem A, Mariappan M, Hutton R, Fitzpatrick J et al. Analgesia for patients undergoing shockwave lithotripsy for urinary stones - a systematic review and meta-analysis. Int Braz J Urol. 2017;43(3):394–406.
2. 2. Muslumanoglu AY, Binbay M, Yuruk E, Akman T, Tepeler A, Esen T et al. Updated epidemiologic study of urolithiasis in Turkey. I: Changing characteristics of urolithiasis. Urol Res. 2011;39(4):309–14.
3. 3. Fouladi A, Soleimani A. Comparison of different analgesic techniques for pain relief during extracorporeal shock wave lithotripsy: a Double-blind, randomized clinical trial. Acta Inform Med. 2017;25(2):94–8.
4. 4. Monk TG, Ding Y, White PF, Albala DM, Clayman RV. Effect of topical eutectic mixture of loca anesthetics on pain response and analgesic requirement during lithotripsy procedures, Anesth Analg 1994;79(3):506–11.
5. 5. Irwin MG, Campbell RC, Lun TS, Yang JC. Patient maintained alfentanil target-controlled infusion for analgesia during extracorporeal shock wave lithotripsy, Can J Anaesth 1996;43(9):919–24.
6. 6. Bach C, Zaman F, Kachrilas S, Kumar P, Buchholz N, Masood J. Drugs for pain management in shock wave lithotripsy. Pain Res Treat. 2011:259426.
7. 7. Bovelander E, Weltings S, Rad M, van Kampen P, Pelger RCM, Roshani H. The Influence of pain on the outcome of extracorporeal shockwave lithotripsy, Curr Urol. 2019;12 (2):81–7.
8. 8. Nielsen TK, Bjerggaard JB. Efficacy of commercialised extracorporeal shock wave lithotripsy service: a review of 589 renal stones, BMC Urol. 2017;17(1):59.

9. 9. Yılmaz Ö, Saraçoğlu F, Şenkul T, Zor M, Soydan H, Malkoç E et al. The Effect of pre-procedure anxiety on pain perception during first session of shock wave lithotripsy, J Urol Surg 2016;3(1):18–21.
10. 10. McDonald PF, AM Berry. Topical anaesthesia for extracorporeal shock wave lithotripsy, Br J Anaesth. 1992;69(4):399–400.
11. 11. Akcali GE, Iskender A, Demiraran Y, Kayikci A, Yalcin GS, Cam K, et al. Randomized comparison of efficacy of paracetamol, lornoxicam, and tramadol representing three different groups of analgesics for pain control in extracorporeal shockwave lithotripsy. J Endourol. 2010;24: 615–20.
12. 12. Kiaei MM, Mohaghegh MR, Movaseghi G, Ghorbanlo M. Enteral diclofenac controls pain and reduces intravenous injection during extracorporeal shock wave lithotripsy, Eur J Transl Myol 2018;28(2):73–53.
13. 13. Han YY, Lu HC, Tsai HJ, Hseu SS, Chan KH, Tsai SK. T he analgesic effect of oral morphine or pentazocine for extracorporeal shock wave lithotripsy. Acta anaesthesiologica Sinica 2003;41:27–32.
14. 14. Eryıldırım B, Kuyumcuoğlu U, Tarhan F, Faydacı G, Uruç F. Comparison of three analgesic treatment protocols for pain management during extracorporeal shock wave lithotripsy. Urologia internationalis 2009;82:276–9.