Effectiveness of Topical Eutectic Mixture of Local Anesthetics (EMLA) on Pain Response and Sedatives Requirement during Extracorporeal Shock Wave Lithotripsy

Abstract

Nowadays a majority of patients with urolithiasis are treated primarily with extracorporeal shock wave lithotripsy (ESWL). Almost 50% of the patients need intravenous anesthetics with subsequent extensive vital signs monitoring during the ESWL procedure. A trial was carried out, of local application of a eutectic mixture of local anesthetics (EMLA) in patients with urolithiasis to assess the pain and the consumption of anesthetics during the ESWL procedure. From April to May 1995, a total of 40 patients were enrolled in this study. They were randomly divided into study and control groups. EMLA cream (2.5% lidocaine and prilocaine, 30 gm, Astra Pharmaceutical) was applied to 20 patients at least 90 minutes before the ESWL procedure, and 20 patients without EMLA application served as controls. The verbal pain scoring and systemic analgesic requirement were recorded. The results showed that there was no significant difference between the two groups in terms of pain score and sedative requirements. In conclusion, topical EMLA application alone is not effective for pain control in ESWL treatment of stone patients.