Comparison of Two Analgesics for Extracorporeal Shock Wave Lithotripsy: Case Study at Warinchumrab Community Hospital, Ubonratchathani, Thailand

Abstract

Objective: The aim of the study was to compare the clinical efficacy of two different analgesic drugs with respect t o their level of analgesic, adverse effects, cost-effectiveness, and satisfaction post - extracorporeal shock wave lithotripsy (ESWL) procedure.
Patients and Methods: One hundred and forty patients were randomly divided into two groups. The first seventy patients (group M) received mefenamic acid 1,000 mg, paracetamal 1,000 mg and diazepam 5 mg orally and the second seventy patients (group T) received tramadol 100 mg, paracetamal 1,000 mg and diazepam 5 mg orally, 30 minutes before lithotripsy. Blood pressure and pulse rate were recorded before the procedure, then every 15 minutes during the procedure and at the end of the procedure. Pain intensity was identified with a visual analogue scale (VAS). Adverse effects were recorded during the procedure and before discharge and cost-effectiveness were also recoded before discharge. All patients were asked to assess their satisfaction before discharge.
Results: There were no statistically significant difference (p>0.05) among the two groups with regard to characteristic of patients, adverse effects and patients/surgeon satisfaction. But in group M pain, blood pressure and pulse rate were changed more than group T statistically significant difference (p<0.05). However in group M cost - effectiveness after ESWL was more than group T statistically significant difference (p<0.05).
Conclusion: Mefenamic acid (1,000 mg) and tramadol (100 mg) were found to be safe and effective analgesics during ESWL, but Mefenamic acid had better cost-effectiveness.