Painless ESWL by cutaneous application of vaseline

In a prospective study we investigated the efficacy of cutaneous vaseline application in pain reduction during ESWL. In 150 patients (group 1) vaseline was applied on a skin area of 10 x 20 cm corresponding to the entry site of shock waves directly before ESWL was started. In 75 patients (group 2) ESWL was performed without vaseline. 10/150 (6.7%) in group 1 and 27/75 (36.4%) in group 2 (p < 0.001) needed additional analgesic sedation. Requirement for supplementary analgosedation was most pronounced for patients with lower calyceal and distal ureteral stones [20% and 19% in group 1; 53% and 78% in group 2 (p < 0.03)]. The median pain score in group 1 was 2.5 +/- 1.05, in group 2 4.25 +/- 1.13 (p < 0.05). Local vaseline application significantly reduced pain during ESWL independent from stone location. Because of its high viscosity vaseline inhibited the development of cavitation bubbles at the skin surface. Cutaneous vaseline application reducing the need for analgesic sedation might especially be useful in outpatient ESWL procedures.