Comparative Study between Three Analgesic Agents for the Pain Management during Extracorporeal Shock Wave Lithotripsy

• Main Authors: Jianjun Liu, Yun-Jiang Zang
• Format: Article
• Language: English
• Published: Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences 2013-09-01
• Series: Urology Journal
• Subjects: Comparative Study; Pain Management
• Online Access: http://www.urologyjournal.org/index.php/uj/article/view/1458/747
• ISSN: 1735-1308; 1735-546X

Purpose: To compare the clinical efficacy between locally applied diclofenac diethylamine gel,EMLA cream and systemically given diclofenac sodium for the pain relief during extracorporealshock wave lithotripsy (SWL) using Dornier Delta Compact Lithotripter.Material and Methods: One hundred five patients with renal stones were randomly divided in to3 groups. Group A was given intramuscular diclofenac sodium (1 mg/kg), 45 minutes before theprocedure. In group B, 10 gm of eutectic mixture of local anesthetic (EMLA) cream and in groupC, 15 gm of diclofenac diethylamine gel was applied locally 45 minutes before the procedure.Ten-score linear and visual analogue scale (VAS) was used to assess the severity of pain duringthe procedure. Analysis of variance (ANOVA) test was used to compare various parameters andanalyzed statistically.Results: All the three groups were not statistically different with respect to age, weight, stonesize, number of shock wave delivered and maximum voltage used (P > .05). The mean pain scorein group A was 4.48, in group B was 3.60 and in group C was 3.95, which were not significantlydifferent (P = 1.34). Complication like skin lesion was found only in injection diclofenac sodiumgroup whereas cold sensation at the local site was typically found in diclofenac diethylamine gelgroup.Conclusion: Although not statistically significant, the mean pain score in locally applied analgesicagents (EMLA and diclofenac diethylamine gel) is lower as compared to intramuscularly given diclofenacsodium. Among these two locally acting drugs, diclofenac diethylamine gel is an equallyeffective alternative to EMLA.