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

Abstract

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.