Related Experiment Videos
Topical anaesthesia for extracorporeal shock wave lithotripsy
1Department of Anaesthetics, Royal Perth Hospital, Western Australia.
British Journal of Anaesthesia
|October 1, 1992
Summary
Eutectic Mixture of Local Anaesthetics (EMLA) cream did not significantly reduce fentanyl use in patients undergoing extracorporeal shock wave lithotripsy (ESWL). This study found no analgesic benefit from EMLA cream during ESWL procedures.
Area of Science:
- Anesthesiology
- Urology
- Pharmacology
Background:
- Extracorporeal shock wave lithotripsy (ESWL) is a common procedure for kidney stone treatment.
- Pain management during ESWL is crucial for patient comfort and procedural success.
- Topical anesthetics are sometimes used to reduce procedural pain.
Purpose of the Study:
- To evaluate the efficacy of Eutectic Mixture of Local Anaesthetics (EMLA) cream in providing analgesia during ESWL.
- To determine if EMLA cream can reduce the need for supplemental intravenous fentanyl during ESWL.
Main Methods:
- Prospective, double-blind, placebo-controlled study involving 60 patients.
- EMLA cream or placebo applied to the skin at the shock head-skin interface before ESWL.
- Intravenous fentanyl administered on patient demand during the procedure.
Main Results:
- No statistically significant difference in the total dose of fentanyl administered between the EMLA and placebo groups (P = 0.83).
- EMLA cream did not demonstrate a measurable analgesic effect in this ESWL setting.
- Patient-controlled analgesia with fentanyl was required in both groups.
Conclusions:
- EMLA cream is not recommended as an analgesic adjunct for extracorporeal shock wave lithotripsy (ESWL) using a second-generation lithotriptor.
- Further research may be needed to explore alternative or multimodal pain management strategies for ESWL.
- The findings suggest that topical EMLA cream does not provide sufficient analgesia to alter opioid requirements during ESWL.