ESWL: Comparing two analgesic techniques. Our experience

Area of Science:

• Urology
• Pain Management
• Medical Devices

Background:

• Extracorporeal shockwave lithotripsy (ESWL) is a common procedure for kidney and ureteral stones.
• Pain and efficacy are key considerations in ESWL treatment.
• Current analgesia protocols aim to optimize patient comfort and treatment success.

Purpose of the Study:

• To compare the efficacy of intramuscular analgesia alone versus a combination of intramuscular and topical analgesia (Luan gel with 1% lidocaine) for ESWL.
• To evaluate the impact of this combined approach on stone-free rates and treatment parameters.

Main Methods:

• A study involving 300 patients undergoing ESWL for kidney or upper ureteral stones.
• Group A received standard intramuscular analgesia (Ketorolac, Tramadol, Betamethasone).
• Group B received the same intramuscular regimen plus topical Luan gel during the procedure.

Main Results:

• The stone-free rate at 3 months was 61% in the intramuscular analgesia group (Group A) versus 79% in the combined therapy group (Group B).
• Lower treatment energy levels were used in the combined therapy group.
• The combined approach demonstrated a higher success rate.

Conclusions:

• Topical Luan combined with intramuscular analgesia is recommended for ESWL of kidney stones (≤20 mm) and ureteral stones (≤15 mm).
• This strategy enhances ESWL efficacy and improves patient comfort.
• The findings suggest a superior approach to pain management and treatment outcomes in ESWL.