Topical EMLA for pain control during extracorporeal shock wave lithotripsy: prospective, comparative, randomized,...

Area of Science:

• Urology
• Anesthesiology
• Nephrology

Background:

• Patient cooperation is crucial for effective external shock wave lithotripsy (ESWL).
• Optimal analgesic selection is essential for successful ESWL procedures.
• Ureteral and renal lithiasis necessitate effective pain management during ESWL.

Purpose of the Study:

• To compare the efficacy of EMLA cream plus intravenous (i.v.) pethidine versus i.v. pethidine with placebo cream for ESWL.
• To evaluate pain relief and stone fragmentation in patients undergoing ESWL.

Main Methods:

• Prospective, controlled, randomized, double-blind study design.
• Patients undergoing ESWL were randomized into two groups: EMLA cream plus i.v. pethidine (Group A) or placebo cream plus i.v. pethidine (Group B).
• Pain was assessed using the Visual Analogue Scale (VAS), and stone fragmentation was evaluated.

Main Results:

• EMLA cream combined with i.v. pethidine demonstrated significantly better pain relief (VAS scores) compared to placebo.
• Improved lithiasis fragmentation was observed in the EMLA group.
• The combination therapy led to more completed ESWL treatments and decreased patient withdrawal rates.

Conclusions:

• Topical EMLA cream combined with i.v. pethidine is an effective analgesic strategy for ESWL.
• This combination enhances patient comfort, improves treatment outcomes, and reduces procedure abandonment.
• EMLA cream offers a significant benefit in managing pain and improving fragmentation during ESWL for renal and ureteral stones.