Tamayo-Valenzuela A, Jaramillo-Talavera J, Vásquez-De Anda F, Calderón-Orozco I

Language: Spanish
References: 15
Page: 140-143
PDF size: 94.46 Kb.

ABSTRACT

Objective: To evaluate the effectiveness of sodium diclofenac analgesia in extracorporeal lithotripsy. Material and methods: Thirty patients were divided into two groups. Group I received 75 mg IV diclofenac thirty minutes before the procedure started. Group II received 0.1 mg fentanyl five minutes before the procedure started. Pain was measured at 5-minutes intervals. Vital signs and arterial oxygen saturation were monitored. In case of severe pain,fentanyl was used as rescue analgesia. Later on, severity of pain and oxygen saturation level were compared among the two groups. Results: In Group I, before the first 5 minutes of the procedure elapsed, all patients had a score ≥ 2 in the visual analogue scale (VAS). In Group II, 14 out of 15 patients had a score ≤ 2 in the VAS. Statistical analysis yielded a value of p> 0.001 at five minutes. Conclusions: Sodium diclofenac provides satisfactory and effective analgesia for this type of procedure. Diclofenac does not depress respiratory automatism; arterial oxygen saturation did not decrease in any of the patients receiving sodium diclofenac.

REFERENCES

1. Chaussy C, Schmidt, Jocham D, Brendel W, Frossman B, Walter V. First clinical experience with extracorporeally induced destruction of kidney stones by shockwaves. J Urol 1982;127:417-20.

2. Chia YY, Liu K. Prospective and randomized trial of intravenous tenoxicam versus fentanyl and tramadol for analgesia in outpatient extracorporeal lithotripsy. Acta Anaesthesiol Sin 1998;36:17-22.

3. Richardson MG, Dooly JW. The effects of general versus epidural anaesthesia for outpatient extracorporeal shockwave lithotripsy. Anesth Analg 1998;86:1214-8.

4. Shenkman Z, Eidelman L, Cotev S. Continuous spial anaesthesia using a standard epidural set for extracorporeal shockwave lithotripsy. C J Anaesth 1997;44:1042-6.

5. Wheelahan JM, Leslie K, Silbert BS. Epidural Fentanyl reduces the shivering threshold during epidural lidocaine anaesthesia. Anesth Analg 1998; 87:587-590

6. Dawson C, Vale JA, Corry DA, Cohen NP, Gallagher, Nockler IB, Whitfield HN. Choosing the correct pain relief for extracorporeal lithotripsy. Br J Urol 1994;74:302-7.

7. White PF. Use of patient-controlled analgesia for management of acute pain. JAMA 1988;259:243-7.

8. Chin CM, Tay KP, Ng FC, Lim PHC, Ching HC. Use of patient controlled analgesia in extracorporeal shockwave lithotripsy. Br J Urol 1997;79:848-51.

9. Notcutt WG, Knowles P, Kaldas R. Overdose of opioid from patient controlled analgesia pumps. Br J Anaesth 1992;69:95-7.

10. Monk TG, Ding Y, White P, Albala DM. Effects of Topical Eutectic mixture of local anesthetics on pain response during lithotripsy. Anesth Analg 1994;79:506-11.

11. Ganapathy S, Razvi H, Moote C, Prakin J, Ye I, Gvezdys S, Dain S, Denstedt, JD. Eutectic mixture of local anesthetics is not effective for extracorporeal shockwave lithotripsy. C J Anaesth 1996;43:1030-4.

12. Aybekn Z, Turan T, Yonguc T Bozbay C, Atahan O, Tuncay OL. Requirements of analgesia for extracorporeal shockwave lithotripsy and efficacy of a nonsteroidal anti-inflammatory drug: piroxicam. Eur Urol 1998;34:207-9.

13. Iannarone C, Tellan G, Fegiz A, Levato C, Baumgartner IAM, Fantera A. Analgesia and sedation with propofol-NSAIDs for day hospital extracorporeal shock wave lithotripsy (ESWL). Eur Rev Pharmacol Sci 1997;1:203-6.

14. Souter AJ. Nonsteroidal anti-inflammatory drugs. In: Intravenous Anesthesia. (White P ed.) Williams &Wilkins, Baltimore, 1997.pp. 247-58.

15. Insel PA. Analgesic-antipyretic and anti-inflammatory agents and drug employment in the treatment of gout. In: Goodman & Gilman´s The Pharmacological Basis of therapeutics (Hardman JG, Limbird L, Molinoff PB, Ruddon RW, Goodman A. eds) McGraw-Hill, New York. 1996.pp. 617-57.