A COMPARATIVE STUDY ON THE EFFECT OF MIDAZOLAM OR MELATONIN IN CONTROLLING THE PAIN IN EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY (ESWL)

Abstract

Introduction: Due to the need to control pain during lithotripsy, this study was conducted to compare the effect of midazolam and melatonin during extracorporeal shock wave lithotripsy. Methods: The study was conducted on 45 patients referred to lithotripsy ward of Peymanieh Hospital in Jahrom, who were candidate for extracorporeal shock wave lithotripsy. They were randomly selected. All patients had kidney stones in the upper ureter beginning with a diameter of 8 mm to 20. Patients were divided randomly into three groups (each containing 15 patients). The first group received melatonin 3mg pills orally (po), the second group received Midazolam 0.1 mg (IV), and the third group was considered as control group. Placebo was prescribed orally in capsule form. Two hours before surgery, patients were randomly given melatonin pills or midazolam ampoule. Then, in all three groups, lithotripsy was conducted in the supine position with fluoroscopic guidance using standard method. Data were analyzed by analysis of variance spss version 21 software. Results: 45 patients (57.8% female and the rest male) with a mean age of 32.65 ± 5.05 were randomly divided into three groups of 15 people (Melatonin, midazolam and control) Data analysis showed that there was no significant difference among three groups of melatonin, midazolam and control in terms of size and age of stone (p> 0.05), but there was a significant difference in the number of shock (p <0.05). The number of shocks in the midazolam was higher than two other groups. In addition, the highest mean pain was seen in the melatonin group and the lowest mean pain was seen in midazolam group. Conclusion: midazolam is a suitable and effective that can be used in outpatient basis without need for continuous monitoring in patients undergoing extracorporeal shock wave lithotripsy.