Analysis of the Subjective Pain and Need of Analgesics during Shockwave Lithotripsy

Hyeong Gon Kim; Byung Ki Lee; Sung Hyun Paick; Yong Soo Lho

doi:10.4111/kju.2007.48.3.310

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Kim, Lee, Paick, and Lho: Analysis of the Subjective Pain and Need of Analgesics during Shockwave Lithotripsy

Original Article

Korean J Urol 2007;48(3):310-314.

Published online: 18 December 2007

DOI: https://doi.org/10.4111/kju.2007.48.3.310

Analysis of the Subjective Pain and Need of Analgesics during Shockwave Lithotripsy

Hyeong Gon Kim, Byung Ki Lee, Sung Hyun Paick, Yong Soo Lho

¹From the Department of Urology, Konkuk University College of Medicine, Seoul, Korea

Corresponding Author: Noh Yongsu Konkuk University College of Medicine Department of Urology, Konkuk University Hospital 4-12 Hwayang-dong, Gwangjin-gu, Seoul 143-729 TEL: 02-2030-7671 FAX: 02-2030-5324 E-mail: drsilent@khu.ac.kr

Received 2 December 2005 Accepted 18 October 2006

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose:

The subjective pain felt by patients during shockwave lithotripsy (SWL) and need of analgesics in patients with urinary stones were investigated.

Materials and Methods:

Between September 2004 and January 2006, one hundred and ninety seven SWLs were undertaken (151 patients) using a SDS 5000 (spark gap type, Comed, Korea). Ninety-five and 102 cases proceeded without premedication (no analgesics group) and diclofenac sodium, 1mg/kg IM, respectively, 30 minutes before lithotripsy (analgesics group). After the procedure, the subjective pain was estimated using a prospective questionnaire, with a 10-point visual analogue scale.

Results:

The average subjective pain scores were 3.77 and 3.25 in the non analgesics and analgesics groups, respectively. There was no significantly difference between the two groups. However, the pain scores in the analgesics group were significantly lower in females (3.37 vs. 4.71) and cases of first SWL (3.10 vs. 4.09). In the no analgesics group, the pain score was not affected by the laterality, stone size, location of stone and tolerability, but was affected by sex, age and number of SWL attempts. In the analgesics group, the pain score was only affected by age. Seventy eight percent (74/ 95) and 63% (64/102) of the patients in the no analgesics and analgesics groups agreed that analgesic should not be recommended to other patients.

Conclusions:

The subjective pain during SWL was tolerable; therefore, routine analgesics are not required. However, on the initial SWL in young female patient, the application of analgesics is considerable.

Keywords: Urinary stone, Shockwave lithotripsy, Analgesics, Pain

REFERENCES

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Table 1.

Comparison of visual analogue pain scores between the no analgesics and analgesics groups in relation to clinical factors

		Analgesics		No analgesics		p-value
		n	Pain score	n	Pain score	p-value
Total		95	3.77 ±2.35	102	3.25 ±1.92	0.088
Sex
	Male	71	3.45 ±2.44	56	3.14±1.88	0.438
	Female	24	4.71 ±1.81	46	3.37±1.98	0.007∗
Age
	<40	47	4.32 ±2.05	43	3.70±1.78	0.130
	>40	48	3.23 ±2.52	59	2.92 ±1.97	0.471
Laterality
	Left	49	4.04 ±2.61	58	3.26±1.80	0.071
	Right	46	3.48 ±2.03	43	3.21 ±2.11	0.565
Location
	Lower	26	4.19±2.28	16	3.88±1.82	0.640
	Upper	57	3.79 ±2.25	61	3.12±1.93	0.090
	Renal	12	3.00 ±2.92	25	3.04 ±1.95	0.961
Size (mm)
	<5	34	3.47 ±2.73	29	2.90 ±2.04	0.356
	>5	61	3.93 ±2.12	73	3.38±1.87	0.112
No. of SWL
	1	70	4.09 ±2.41	81	3.10±1.93	0.006∗
	>1	25	2.88 ±1.99	21	3.81 ±1.83	0.109
Need of analgesics
	Need	21	5.71 ±2.28	38	3.92 ±1.94	0.002∗
	No need	74	3.22 ±2.08	64	2.84±1.81	0.267
Patience
	Patient	24	3.17±2.57	20	2.80±1.94	0.602
	Impatient	71	3.97 ±2.26	82	3.35±1.91	0.069

^∗ p < 0.05. SWL: shockwave lithotripsy

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