Is pain perception different in pediatric and adult patients undergoing stone crushing procedure after the application of multimodal analgesia?

Engin Özbay,Erim Erdem

doi:10.23950/jcmk/11231

Abstract

Aim: Extracorporeal shock wave lithotripsy (ESWL) is an important modality in the treatment of urinary system stone disease in children and adults. However, ESWL may be painful and stressful procedure. We aimed to examine the differences between pain perception felt during ESWL in children and adult patients after the application of multimodal analgesia. Method: Patients who underwent the stone crushing procedure under multimodal analgesia at the ESWL unit of Mersin University Hospital Urology Clinic between May 2010 and December 2010, were divided into two groups as pediatric and adult. Using the VAS form, the adult patients’ and pediatric patients' pain perception felt during ESWL, were scored and compared. Results: The difference between the mean scores of pain perception felt during ESWL were not significant for all three sessions in both groups. But the difference between the mean scores of pain perception felt during all ESWL sessions between the pediatric and adult groups were significant for all three sessions. The success rate for SWL was calculated as 83.3% for the pediatric group and 80% for the adult group. Conclusion: ESWL is a painful procedure. Our ESWL success rate is compatible with the literature. The pediatric and adult patients successfully completed the ESWL procedure with multimodal analgesia. The pain perception felt during ESWL score was higher in pediatric cases.

Highlights

The incidence of renal stone disease varies between 1-20%, and countries where it reaches up to 37% are followed [1, 2]
We aimed to evaluate the pain perception felt during Extracorporeal shock wave lithotripsy (ESWL) with recording Visual Analog Scale (VAS) scores in children and adult patients after the application of multimodal analgesia and to compare the both group’s pain perception felt during ESWL
By analyzing VAS scores related to ESWL sessions, we aimed to examine the differences between pain perception felt during ESWL in pediatric and adult patients after the application of multimodal analgesia

Summary

Introduction

The incidence of renal stone disease varies between 1-20%, and countries where it reaches up to 37% are followed [1, 2]. Pediatric stone disease accounts for 2-3% of all stone disease cases and ıt is most common in children of both sexes, between the ages of 5 and 7 years [3]. Symptoms of renal stone-related flank pain, abdominal pain, urinary infection and hematuria can be seen. If the treatment of renal stone is not performed at the appropriate time, secondary diseases due to pain, urosepsis, renal dysfunction and end-stage renal failure may be observed [4]. Medical and interventional treatment procedures are available for the treatment of renal stone disease. ESWL is highly preferred in the interventional treatment procedure [4]

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