Analgesic Efficacy of Ketorolac for Shock Wave Lithotripsy

Abstract

OBJECTIVE: A single-blind, randomized control study was designed to compare the efficacy of a single intravenous dose of 30 mg ketorolac with that of 0.1 mg fentanyl in a shock wave lithotripsy (SWL) procedure for treatment of urolithiasis, and to monitor side effects. MATERIAL AND METHODS: From June to December 1999, 152 patients (108 males and 44 females) were enrolled, with 79 patients in the fentanyl group and 73 in the ketorolac group. Pain relief was assessed by a verbal rating scale (VRS) and a visual analog scale (VAS) at 5, 15, and 30minutes after the beginning of the SWL procedure. RESULTS: At each time point, patients in the fentanyl group showed more significant pain relief than did patients in the ketorolac group (p＜0.05). There were 21 patients (28.8%) in the ketorolac group who needed intravenous 50 mg pethidine as rescue medication, while only 8 patients (10.1%) in the fentanyl group did. The difference is statistically significant (p＜0.05). CONCLUSIONS: Ketorolac cannot completely replace fentanyl for pain control during SWL treatment of urolithiasis with respect to pain level over time and the number of patients requiring rescue medication, but its lower central and respiratory depression provides another choice for patients with cardiopulmonary diseases.