COMPARISON OF ANALGESIC EFFECT OF PREGABALIN AND MELATONIN IN PATIENTS UNDERGOING SHOCK WAVE LITHOTRIPSY: A RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY

Abstract

Introduction : Extracorporeal shock wave lithotripsy (ESWL) is an effective non-invasive treatment option for kidney stones. ESWL has a lower complication rate compared to percutaneous nephron lithotomy (PNL) however with increased use of ESWL post-procedural complications associated with it are becoming recognized. Post-ESWL renal colic and pain accounts for 40% of ESWL associated complications. There has been some evidence suggesting pre-operative administration of pregabalin or melatonin reduces the analgesic needs of patients. In this study we aimed to examine this hypothesis in patients undergoing ESWL. Methodology : A total of 45 patients, being treated with ESWL at Peymanieh Hospital, Jahrom, Iran, participated in this double blinded randomized control trial. All patients were diagnosed with kidney stones with diameter of 8-20 mm at the beginning of upper ureter. The patients were randomly assigned into three equal groups: Group P (pregabalin capsule 150mg), Group M (melatonin tablets 3mg) and Group C (placebo oral capsules). Each group received treatment 2 hours prior to their ESWL. Pain intensity scores were measured using Visual Analog Scale (VAS) prior to induction of anesthesia and post-operatively for one-hour every 20 minutes. Parametric statistical analyses in form of analysis of variance (ANOVA) were carried out SPSS (version 16). Results and discussion : The mean age in our sample was 32, 65 ± 5, 05. 19 Number in letters were male and 26 Number were female .The results showed no significant difference (p > 0.05) in the pain intensity among three treatment groups (Melatonin, Pregabalin, and Control) post-operatively. Pain intensity in all three groups was significantly higher after ESWL was performed (p < 0.05). Additionally, there was an increase in pain intensity from the first measurement until one-hour post-operatively in the two groups receiving melatonin or pregabalin (group M and P). Conclusion : Perioperative adequate analgesic pain control regimen for an appropriate duration after shock wave lithotripsy is essential to prevent pain to improve patient satisfaction. However, pregabalin or melatonin may not provide the suitable analgesic effect needed