You have accessJournal of UrologyStone Disease: SWL, Ureteroscopic or Percutaneous Stone Removal I1 Apr 20101462 ANALGESIA DURING EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY USING DORNIER (ALPHA COMPACT) LITHOTRIPTOR: A PROSPECTIVE RANDOMIZED DOUBLE BLIND CLINICAL TRIAL Anup Kumar, Manoj Jain, Sanjay Prakash, and Nayan Mohanty Anup KumarAnup Kumar More articles by this author , Manoj JainManoj Jain More articles by this author , Sanjay PrakashSanjay Prakash More articles by this author , and Nayan MohantyNayan Mohanty More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1176AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To evaluate the role of oral ketorolac with occlusive dressing of Eutectic Mixture Of Local Anaesthesia (EMLA), oral alprazolam with occlusive dressing of EMLA and a combination of oral ketorolac,alprazolam with occlusive dressing of EMLA,as three analgesic regimens for pre-medication prior to SWL, to investigate their their efficacy, adverse effects, need for supplemental analgesia, and assess patients' satisfaction and overall treatment outcome. METHODS 150 consecutive patients with urolithiasis scheduled for SWL between May 2008 and December 2008 were randomized equally into 3 groups that were treated using the following protocols: Group A – oral tablet ketorolac 60 min prior to SWL (dosage: 30 mg for body weight <70 Kg, 60 mg for >70 Kg) along with occlusive dressing of a combination of lignocaine and prilocaine (EMLA) 5 gm, applied on a skin area of approximately 30 cm2, corresponding to entry site of the shock waves, 60 min prior to SWL; Group B – oral tablet alprazolam 60 min prior to SWL (dosage: 0.25 mg for body weight <70 Kg, 0.5 mg for >70 Kg) along with occlusive dressing of a combination of lignocaine and prilocaine (EMLA) 5 gm, applied on a skin area of approximately 30 cm2, corresponding to entry site of the shock waves, 60 min prior to SWL; Group C – combination of oral ketorolac, oral alprazolam with occlusive dressing of EMLA, in dosage described above for first two regimens. A Visual Analog Scale (VAS) was used for the subjective evaluation of pain. The various parameters were recorded and analyzed statistically. RESULTS The total number of shock waves delivered, the maximum voltage used and SWL duration were statistically greater in Group C (p <0.001). The VAS scores at 15 min, 30 min, 45 min, 60 min and 120 min, and the supplemental analgesia requirement were statistically lesser in Group C(p <0.001). The stone fragmentation rate, stone free rate at 3 months (89.2%) and modified Efficiency Quotient (0.67) were statistically greater in Group C (p <0.001). The post SWL auxiliary procedure rate and Steinstrasse rates were statistically lesser in Group C. ly greater in Group C (p <0.001). The post SWL auxiliary procedure rate and Steinstrasse rates were statistically lesser in Group C. CONCLUSIONS The use of a combination of oral ketorolac,alprazolam and an occlusive dressing of EMLA cream during SWL provides adequate analgesia with minimal morbidity, avoids the need for parenteral analgesics and their side effects and additionally improves the success rate of SWL. Delhi, India© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e563 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Anup Kumar More articles by this author Manoj Jain More articles by this author Sanjay Prakash More articles by this author Nayan Mohanty More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...