Ideal Analgesia in Day Care Extra Corporeal Shockwave Lithotripsy for Renal Stones: A Single Centre Randomised Controlled Study
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 2
Abstract
Abstract: Extracorporeal shock wave lithotripsy (ESWL) is the main day care treatment modality for small renal stones. Good pain relief with least sedative effect is one of the main criteria for an effective day care ESWL. The aim of this study was to compare efficacy of Meperidine with Pentazocine in day care ESWL. One hundred patients with treated with ESWL were randomized into two groups. Group-EM received EMLA cream with injection meperidine 1 mg/kg body weight; Group-EP received EMLA cream with injection pentazocine 0.8mg /kg body weight. Pain during ESWL was assessed using visual analogue pain scale (VAS). Age, weight, height, body mass index (BMI), stone size, stone location, duration of ESWL, total shock waves performed, mean energy level (kV)and stone fragmentation were analysed for each patient. 47 patients in EM group and 46 patients in EP group were analysed. Both groups were similar w.r.t respect to age, sex, BMI and stone burden. Patients in EM group perceived less pain (VAS score 3.17 ±1.06 vs 3.63 ±1.72) and could tolerate higher energy shocks (3.09 ± 0.45 vs 2.93± 0.68). Number of shocks used was less (though it did not achieve statistical significance) in EM group compared to EP group (2980 ± 514 vs 3340± 348) with a shorter duration of procedure (49.67±10.63 mins vs 55.68±6.54mins). Both overall stone clearance and clearance after 1st session of ESWL was better in the EM group [(78.72% vs 71.74%) and (57.44% vs 52.17%)]. EM group had higher satisfaction rate (72.34% vs 63.04%). Meperidine group had significantly lower respiratory rate (9.19±1.11 vs 13.18±1.13), however no patients had respiratory depression, all had normal post-procedure oxygen saturation. Reducing the pain with a single injection of meperidine is good day care analgesia and is superior to pentazocine when used along with EMLA.
Authors and Affiliations
Dr. Debansu Sarkar, Dr. Saikat Mojumdar, T. K. Mandal, Dr. Dipankar Gayen
Keywords
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