Characteristics and treatment outcome of patients requiring additional intravenous analgesia during extracorporeal shockwave lithotripsy with Dornier Compact Delta Lithotriptor

• DOI: 10.1007/s11255-006-9124-3
• Publication Date: 2007-02-23T12:01:53Z
• Authors: Chi-Fai Ng; Trevor Thompson; David Tolley
• Keywords: Adult; Male; Middle Aged; 3. Good health; Analgesics, Opioid; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Lithotripsy; Humans; Female; Urinary Calculi; Alfentanil; Analgesia; Preanesthetic Medication; Aged; Retrospective Studies

To investigate the effect of additional intravenous analgesia (besides oral analgesic premedication) on the treatment outcome in patients receiving extracorporeal shock wave lithotripsy (SWL) with Dornier Compact- Delta lithotriptor.Five hundred and twenty adults receiving SWL for solitary urinary stone of size </=10 mm were retrospectively reviewed. They received the same analgesic protocol--oral diclofenac 50 mg as premedication and additional intravenous bolus alfentanil if they experienced discomfort during ESWL. After reviewing the analgesic usage, they were divided into two groups, Group-A--received oral analgesic alone and Group-B--received both oral and additional intravenous analgesia during ESWL. Treatment outcome of the two groups was then compared.There were 306 patients in Group-A and 214 patients in Group-B. The stone-free rates at 3-month for Group-A and -B were 38.2% and 44.9% respectively (P = 0.100). The re-treatment/auxiliary procedure rates for the Group-A and Group-B were 40.8%/12.7%, and 35.0%/18.2% respectively. The additional use of intravenous analgesia improved the effectiveness quotient by 17.7% [from 0.249 (Group-A) to 0.293(Group-B)].The additional use of intravenous analgesia during SWL with Dornier Compact Delta lithotriptor resulted in improvement of effectiveness quotient.