Effectiveness of eutectic mixture of local anesthetic cream and occlusive dressing with low dosage of fentanyl for pain control during shockwave lithotripsy


Yilmaz E., Batislam E., Murad Basar M., TUĞLU D., Ozcan S., Basar H.

Journal of Endourology, vol.19, no.5, pp.589-594, 2005 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Abstract
  • Volume: 19 Issue: 5
  • Publication Date: 2005
  • Doi Number: 10.1089/end.2005.19.589
  • Journal Name: Journal of Endourology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.589-594
  • Lokman Hekim University Affiliated: No

Abstract

Background and Purpose: To investigate the effect and usefulness of Eutectic Mixture of Local Anesthetic (EMLA) applied with an occlusive dressing and used simultaneously with a low dose of fentanyl during shockwave lithotripsy (SWL). Patients and Methods: One hundred sixty patients with kidney stones, aged between 19 and 68 years, were randomly divided into seven groups that were treated as follows: group 1: fentanyl 1 μg/kg by intravenous infusion (IV); group 2: IV fentanyl 0.25 μg/kg; group 3: occlusive dressing and IV fentanyl 0.25 μg/kg; group 4: placebo cream and IV fentanyl 0.25 μg/kg; group 5: EMLA cream and IV fentanyl 0.25 μg/kg? group 6: placebo cream and IV fentanyl 0.25 μg/kg with an occlusive dressing; and group 7: EMLA cream and IV fentanyl 0.25 μg/kg with an occlusive dressing. The mean arterial pressure (MAP), heart rate, ventilatory rate, and oxygen saturation (SpO2) were recorded on all patients. A visual analog scale 0-100 mm (VAS) was used for the evaluation of pain. The skin integrity was inspected to detect any lesions after SWL. Results: The SpO2 in group 1 was lower statistically than in the other groups. The VAS score in group 7 was clearly lower than in the others in the first, tenth, and twentieth minutes and at the end of SWL. In groups 6 and 7, additional fentanyl doses were lower than in the other groups, but only in group 7 was the total fentanyl dosage low. Skin lesions were not seen only in groups 3, 6, and 7. Conclusion: Use of EMLA and an occlusive dressing with low doses of fentanyl during SWL provides appropriate analgesia with minimal morbidity. © Mary Ann Liebert, Inc.