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Comparing two local anesthesia techniques for extracorporeal shock wave lithotripsy.
Erkan Demir1, Mete Kilciler, Selahattin Bedir
1Department of Urology, Gulhane Military Medical Academy School of Medicine, Ankara, Turkey. demir74@superonline.com
Urology
|April 21, 2007
Summary
Dimethyl sulfoxide (DMSO) with lidocaine provided superior pain relief during extracorporeal shock wave lithotripsy (ESWL) compared to eutectic mixture of local anesthetics (EMLA) cream. DMSO significantly reduced pain scores, making ESWL more tolerable for patients.
Area of Science:
- Urology
- Anesthesiology
- Pain Management
Background:
- Extracorporeal shock wave lithotripsy (ESWL) is a common procedure for kidney stone removal.
- Pain management during ESWL is crucial for patient comfort and procedure success.
- Topical anesthetics are often used to mitigate pain during ESWL.
Purpose of the Study:
- To compare the efficacy of eutectic mixture of local anesthetics (EMLA) cream versus a dimethyl sulfoxide (DMSO) and lidocaine mixture for pain control during ESWL.
- To evaluate patient-reported pain levels using a visual analog scale.
Main Methods:
- A prospective randomized study involving 167 patients undergoing ESWL.
- Patients received either EMLA cream (n=85) or 40% DMSO with lidocaine (n=82) applied topically.
- Pain was assessed using a 10-point visual analog scale.
Main Results:
- 94% of patients in the EMLA group experienced tolerable pain (mean score 5.2 +/- 1.3).
- 98% of patients in the DMSO group experienced tolerable pain (mean score 3.7 +/- 1.1).
- The DMSO group reported significantly lower pain scores than the EMLA group (P = 0.011).
Conclusions:
- DMSO with lidocaine is more effective than EMLA cream in reducing pain during ESWL.
- DMSO's potential diuretic, anti-inflammatory, muscle relaxant, and antioxidant properties may contribute to its efficacy.
- Further research is warranted to explore these additional effects of DMSO in ESWL patients.
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