[Oral tramadol for extracorporeal shock wave lithotripsy]

Two hundred patients undergoing shock wave lithotripsy for renal calculi with the improved version of Dornier HM3 lithotripter system were randomly divided into group A and group B with 100 patients in each. Patients in group A were orally given tramadol 100 mg and lorazepam 1 mg and those in group B flunitrazepam 1 mg was given. Those in group A, who did not need supplemental medication during ESWL were subdivided in group A while those who needed an adjuvant of 100 micrograms intravenous fentanyl were subdivided in group A2. Like group A, those in group B, who did not need supplemental drug and those who needed 100 micrograms intravenous fentanyl were respectively subcategorized into groups B1 and B2. Drugs were given with 15 mL water 30 min prior to ESWL. Pre-operatively, an intravenous line and monitoring system which included noninvasive blood pressure and pulse oximeter were established. The entire course was divided into 5 stages i.e. stage I (prior to oral medication), stage II (10 min after medication), stage III (10 min following ESWL), stage IV (5 min following 100 micrograms intravenous fentanyl) and stage V (10 min after ESWL). The mean blood pressure, heart rate and SpO2, pain scale, sedation scale and side effects were recorded in various stages. The results showed that in group A 68 patients passed the ESWL smoothly (A1) and 32 patients needed supplemental fentanyl (A2). In group B 70 patients successfully underwent the ESWL (B1) while 30 patients needed supplemental fentanyl (B2). Ther were no significant changes in both groups in various stages regarding heart rate.(ABSTRACT TRUNCATED AT 250 WORDS)