Purpose: The aim of this study was to determine what factors influence the analgesic and sedative requirements during extracorporeal shock wave lithotripsy (ESWL). Materials and Methods: A retrospective study was carried out on 2,103 lithotripsy treatments performed over a 7-year period using an electromagnetic lithotriptor. Treatment with analgesics and anxiolytic drugs administered during ESWL was evaluated, and two new variables to determine the analgesic and sedative requirements were defined. A multivariant analysis model was established to determine which variables are related to or could predict the analgesic and/or sedative drug requirements. Results: The most frequently used sedative drug was potassium chlorazepate which was used in 2,059 patients at a mean total dose of 25.6 mg. Pethidine was used in 2,006 patients at a mean total dose of 56.3 mg, and fentanyl in 995 patients at a dose of 93.3 μg. In 52.4% of patients analgesic requirements were low, and in 76.6% sedative requirements were low. In 21.1% of patients analgesic drug requirements were high, and in 1.8% of patients sedative drug requirements were high. The multivariant analysis showed that those requiring most analgesics were, the younger patients (p = 0.003), those who received a higher number of shock waves (p < 0.001) and those who needed more sedation (p < 0.001). Those who received the greatest amount of sedatives were women (p = 0.0026); younger patients (p < 0.001); those treated with higher voltages (p = 0.032), and patients with the highest analgesic requirements (p < 0.001). Conclusions: Predicting the analgesic drug requirements prior to ESWL is very difficult. The present study shows that young age, a greater discharge of shock waves and a high sedative drug requirement are factors clearly related to greater analgesic drug requirements. Higher sedative drug requirements are needed by women, younger patients, those receiving high discharge voltages and those with higher analgesic requirements.

Keywords:
Extracorporeal shock wave lithotripsy, Urinary calculi, Analgesia, Conscious sedation, Drug utilization
This content is only available via PDF.
© 1999 S. Karger AG, Basel
1999
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.