Comparative Study of Etofenamate and Fentanyl for Outpatient Extracorporeal Shockwave Lithotripsy

Abstract

Objective: This study aimed to compare the clinical efficacy and safety of etofenamate (a non-steroidal anti-inflammatory drug) and fentanyl (an opioid analgesic) for outpatient extracorporeal shock wave lithotripsy (ESWL). Material and Methods: 60 non-premedicated patients underwent ESWL for urinary tract calculus with the Multimed 2000 ’ (ELMED Lithotripsy Co., Turkey) lithotripter. None of patients had previous experience with ESWL treatment. The patients were divided into two groups. A single dose of 1 g etofenamate was given to the patients intramuscularly 25 min before ESWL in group I ( n = 30) and 0.1 mg fentanyl was administered intravenously just before ESWL in group II ( n = 30). At the end of the treatment a visual analogue score (VAS) of 0 (no pain) to 10 (greatest pain) was used to evaluate the pain. Blood pressure, heart rate and arterial oxygen tension ( P aO 2 ) were measured before and during the ESWL. Groups were compared according to the pain scores, stone size, number of shocks, maximum voltage achieved, duration of ESWL and incidence of side-effects of the administered drug. Data were analysed with the Mann-Whitney U -test. Results: No statistical differences were found between the two groups regarding achieved maximal energy levels, pain scores and number of shock waves given ( p < 0.01). Satisfactory stone fragmentation was achieved in both groups. There were no changes in blood pressure or heart rate during the ESWL in either group. P aO 2 was not affected in the etofenamate group, whereas a transient desaturation in two patients and giddiness in three patients were recorded in the fentanyl group. Conclusions: Both etofenamate and fentanyl have clinically sufficient effects on pain, and can be used safely for outpatient ESWL procedures.

• Analgesia Etofenamate Fentanyl Extracorporeal Shock Wave Lithotripsy Eswl