Aplication of dermal blockade in treatment resistance renal colic

APLİCATİON OF DERMAL BLOCKADE İN TREATMENT RESİSTANCE RENAL COLİC Objective:In this study, we aimed to evaluate the results of dermal blockage in patients with treatment-resistant renal colic. Patients and Methods:This retrospective study was conducted with the approval of Adiyaman University Faculty of Medicine Non-Interventional Clinical Research Ethics Committee (2018/5-5).In the study, dermal blockage treatment was applied to 72 patients who admitted to Urology Clinic of Adiyaman University Medical Faculty between September 2013 and May 2018 with resistant renal colic and whose pain had not relieved by medical interventions and results of treatment were evaluated. Dermal blockade was performed as an intracutaneous injection with sterile distilled water at 4 points to accommodate T1 and L4 dermatome regions with predetermined renal colic dermatome. Visual analog scale (VAS) was used to assess pain.The pain status was determined by VAS score before the dermal blockade and were recorded as 0 minutes.Pain status was assessed by VAS score at the 1st, 15th, 30th and 60th minutes after the dermal blockage application.After the dermal blockage, recurrence of pain and relapse time was recorded. Patients with relapsing pain were treated with dermal blockage again. Pain status of the patients who underwent dermal blockage was reevaluated with VAS score.After the treatment, the satisfaction rate and the desire to repeat the procedure were questioned. Results:The mean age of the patients was 34.5 ± 13.92 (19 to 64 years).Of these patients, 45 of them (%62,5) were females and 27 of them (%37,5) were males. Also, 28 of them (%38.9) had pregnancy and 15 of them (%20.8) had renal dysfunction.Of the 72 patients treated with dermal blockage, the pain of 70 (%97.2) them were relieved. While the mean VAS score in the patients was 9.93±0.27 before the dermal blockage procedure (0 min),it was 2,85±1,82, 2,57±1,71, 2,15±1,67, 2,04±1,84 at 1st, 15th, 30th and 60th minutes after the procedure, respectively. The pain of 27 (%37.5) of 70 patients who had dermal blockage treatment was started again.The mean relapse time of the pain was 8.64±2.8 hours. Twent-three(%85.2) of xv these patients were re-treated with dermal blockage. The mean time to repeat dermal blockage was 10.51 ± 3.04 hours after the first dermal blockage. While the mean VAS score was 9.94±0.25 before the repetition of dermal blockage (0. Min), it was 2,85±1,75, 2,65±1,55, 2,03±1,74, 1,91±1,79 at 1st, 15th, 30th and 60th minutes after the procedure. Patient satisfaction rates after dermal blockage treatment were %97,2. satisfied and very satisfied, and desire rate to repeat procedure was %97,2 prefer and definitely prefer. Conclusion:We think that dermal blockage with intracutaneous injection of distilled water is an effective, reliable, cheap, easy to apply and repeatable method for pain control in patients with treatment-resistant renal colic and whose pain had not releved by first-line medical therapies and pregnant women, patients with renal dysfunction.