[Epidural fentanyl provide sufficient analgesia for extracorporeal shock wave lithotripsy (ESWL)]

Epidural fentanyl (0.2 mg in 10 ml normal saline) was administrated in 10 unpremedicated patients undergoing extracorporeal shock wave lithotripsy (ESWL). No test dose of local anesthetics was administrated and accessory drugs such as narcotics or analgesics were not used. Painful procedures except for shock wave such as insertion of urethral catheter were not applied. We observed analgesic effect using original score (grade 0-3) and monitored heart rate, blood pressure, respiratory rate and Spo2 during ESWL. At 1, 2, 3, 4 and 24 hours after ESWL, patients were questioned regarding the presence of postoperative nausea, vomiting, and motor disturbance. At the start of ESWL, nine patients experienced mild pain, although no patient requested additional analgesic treatment. Until the end of ESWL, local anesthetics were administered through the epidural catheter in three patients because of increase of pain, while the others completed ESWL with epidural fentanyl alone. No remarkable change in blood pressure and heart rate were observed. Respiratory rate and Spo2 slightly decreased during ESWL. Postoperative side effects were mild especially in the patients treated with epidural fentanyl alone. Epidural fentanyl is considered to be useful analgesic technique for ESWL.