Can prilocaine infiltration alone be the most minimally invasive approach in terms of anesthesia during extracorporeal shock wave lithotripsy?

摘要

OBJECTIVES: To evaluate the analgesic effect and utility of prilocaine infiltration alone for minimal morbidity during extracorporeal shock wave lithotripsy. METHODS: A total of 114 patients with kidney stones, aged 18 to 69 years, were randomly separated into two groups. The 58 patients in group 1 received intramuscular diclophenac 30 minutes before extracorporeal shock wave lithotripsy, and the 56 patients in group 2 received prilocaine infiltration into the 30 cm2 area below the 12th rib right before the session. A visual analog scale (0 to 100 mm) was used to evaluate pain. RESULTS: The visual analog scale scores for group 2 were statistically lower at 1, 10, and 20 minutes compared with the scores for group 1 (P = 0.006, P = 0.005, and P = 0.006, respectively). However, no difference was detected at the end of the procedure. The requirement for additional analgesic was less in group 2 (P = 0.007). CONCLUSIONS: Prilocaine infiltration alone can be used for analgesic purposes efficiently and safely during extracorporeal shock wave lithotripsy with minimal morbidity.