The comparison of three different analgesies groups for ESWL

Purpose: Extracorporeal Shock Wave Lithotripsy (ESWL) is a noninvasive procedure for the treatment of calculi located in the upper urinary tract. However previous studies indicated that this treatment method is painful, and requires general or regional analgesia during the procedure. The objective of this study was to compare the efficacy and side effect profile of three different analgesic agents.Methods: A total of 90 patients who underwent ESWL treatment at our institution Department of ESWL between August 2006 and February 2007 were randomized into 3 groups (30 in each group). Group I received paracetamol 1 g intravenous, group II received lornoxicam 8 mg intravenous, and group III received tramadol 1 mg/kg intravenous.Visual analog scale (VAS) was utilized to asses the degree of pain related to the ESWL treatment. Hemodynamic parameters (non-invasive sistolic-diastolic mean blood pressure, heart rate, respiratory rate, periferic oxygen saturation) were recorded before the procedure, at the first minute of the procedure and 5 Minutes intervals during ESWL. Also side effects (bradycardia, bradypnea, pruritus, vomiting, headache, and nausea) were recorded. Additionaly both patient and surgeon satisfaction were evaluated.Results: The measurament of hemodynamic parameters revealed no significant difference between these 3 groups. Regarding the VAS values, although the initiation of analgesic effects of these three compounds were relatively similar. Lornoxicam and paracetamol had a forter anelgesic effect than tramadol. On the other hand, it was observed that the anelgesic effects of these 3 agents were similar. Moreover, no significant difference was seen between 3 groups regarding the amount of additional alfentanil, and the degree of patient and surgeon satisfaction. On the other hand, the effect profiles of these 3 agents were also comparable.Conclusions: The results of this study suggest that paracetamol 1 g intravenous, lornoxicam 8 mg intravenous, and tramadol 1 mg/kg intravenous have similar analgesic effects with comparable side effects profile in patients who underwent ESWL treatment.Key Words: ESWL, paracetamol, lornoxicam, tramadol, pain