ABSTRACT
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. 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. 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]. The use of topical piroxicam or lidocaine reduces pain in patients after ESWL It also reduces the need for sedative drugs