Abstract
We evaluated the use of neuroleptanalgesia in 121 patients undergoing extracorporeal shock wave lithotripsy (SWL) with the Sonolith 3000. Neuroleptanalgesia consisting of alfentanil and combinations of droperidol, benzodiazepine, barbiturate and ketamine were administered. The McGill Pain Questionnaire, a widely used test to measure pain that provides valuable information on the sensory, affective, and evaluative dimensions of a painful experience, was utilized to evaluate the patients' experiences. Fifty-eight per cent of the patients described their maximum pain as either mild or discomforting. Eighteen per cent (22) did not experience any pain. Similar numbers of patients described their overall level of comfort as either extremely comfortable (23 patients, 19%) or extremely uncomfortable (18 patients, 16%). The pain was most often described as sharp and the experience as tiring. In the affective categories, the answer with lowest pain score was most often selected (P < 0.05). Only five patients found the experience so unpleasant that they would not undergo the procedure again. No relation between the pain experienced and any characteristic of the stone or the length of time since SWL was identified. Side effects were uncommon and insignificant. Although treatment is not analgesic free, neuroleptanalagesia provides a safe and reliable means of anesthesia for renal lithotripsy with the Sonolith 3000. While accomplishing this, patients are extremely satisfied with the treatment, and treatment success rates remain comparable to those provided by other lithotripters.
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