Introduction & Objective: ESWL is a non-invasive method of
breaking stones, using acoustic shock waves. Shock waves
cause temporary deep visceral pain and discomfort in entry;
therefore, administration of sedatives is necessary. The purpose
of this study was to compare the effect of topical lidocaine and
piroxicam gel with intravenous pethidine in reducing pain during
ESWL.
Materials & Methods: This clinical trial study was performed on
159 patients who referred to Ayatollah Kashani Hospital in
Shahrkord for ESWL in 2009. Patients were randomly divided
into three-groups. For the first group, intravenous pethidine (0.5
mg/kg alone) was administered. The second group received
topical piroxicam, and the third group received topical lidocaine in
the area of flank for half an hour before ESWL. During the
operation, those patients who had unbearable pain, received
another 0.5 mg/kg of pethidine. Data was collected using MC Gill
questionnaires and analyzed using the SPSS software, using
parametric, nonparametric methods and Dunn's Multiple
Comparisons tests.
Results: The mean of pain scores in the first group (pethidine)
was 6.2 ± 6.9 while these scores were 3.2 ± 2 .7 and 3.9 ± 3.1 for
the second (piroxicam gel) and third group (lidocaine gel)
respectively. The differences in the mean score of pain was
significant in the pethidine group compared to the other groups
(P <0.05). The average pethidin consumption were 24 ± 16 mg
for the first group (pethidine), 10 ± 13 mg for the second group
(piroxicam gel), and 5 ± 9 mg for the third group (lidocaine gel).
The mean difference was significant in pethidine treated group in
comparison with other two groups (P < 0.05).
Conclusion: The use of topical piroxicam or lidocaine reduces
pain in patients after ESWL It also reduces the need for sedative
drugs
