Urolithiasis
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Randomized Controlled Trial Comparative Study
Intracutaneous sterile water injection for pain relief during extracorporeal shock wave lithotripsy: comparison with diclofenac sodium.
Various analgesic applications can be used during extracorporeal shock wave lithotripsy (SWL) for pain relief and maximal success rate. Intracutaneous sterile water injection (ISWI) has been shown to be effective in several types of pain, but a gap exists about its use during SWL. In this paper, we aimed to evaluate the effect of ISWI during SWL and compare that with diclofenac sodium injection used commonly to provide ideal patient contentment. ⋯ The characteristics of the patients and shockwave therapy did not differ significantly between the two groups. Although the mean VAS scores prior to SWL and at every voltage increment during the procedure did not differ, more patients in the diclofenac sodium injection group required rescue analgesia with significantly greater side effects. ISWI is found to be as effective as the diclofenac sodium injection for pain management during SWL with lower adverse event rates.
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Randomized Controlled Trial
Comparative evaluation of efficacy of use of naftopidil and/or celecoxib for medical treatment of distal ureteral stones.
We performed a randomized, prospective study to assess the possible role of combined a1D-receptor antagonist naftopidil and nonsteroidal anti-inflammatory hormones celecoxib for the spontaneous expulsion of distal ureteral stones. Patients were randomized to one of the three treatment groups. Treatment group 1 patients received naftopidil 50 mg/day, group 2 patients received naftopidil 50 mg/day plus celecoxib 200 mg (Take two capsules (400 mg) by mouth immediately, then take one capsule (200 mg) by mouth every 12 h), and group 3 patients received celecoxib 200 mg (Take two capsules (400 mg) by mouth immediately, then take one capsule (200 mg) by mouth every 12 h). ⋯ A significant difference was shown for the expulsion rate between the group 3 and the other two groups. (P < 0.001 by log-rank test). Average time to expulsion for groups 1, 2 and 3 was 8.00 ± 2.07, 7.70 ± 2.34 and 10.65 ± 2.92 days, respectively (P = 0.000). Treatment with naftopidil and celecoxib appears to be beneficial in distal ureter stone clearance, shortened the expulsion time, and could be used reliably and successfully to reduce the frequency and intensity of the pain episodes particularly.
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Randomized Controlled Trial
Dermal scarification versus intramuscular diclofenac sodium injection for the treatment of renal colic: a prospective randomized clinical trial.
The aim of the study is to determine whether dermal scarification is equally effective for treating acute renal colic compared to diclofenac sodium intramuscular therapy. A prospective, randomized controlled study was conducted with methodologic rigor based on CONSORT criteria. A total of 291 patients, aged ≥ 18 years, suffering from acute renal colic were included in this trial and randomly assigned in two groups. ⋯ The method was successful in 75.5 % of patients in group A and 74.3 % of patients in group B (p = 0.812). Mean pain reduction was comparable, 5.65 ± 3.05 in group A and 5.34 ± 2.99 in group B (p = 0.379), with dermal scarification eliciting its effect considerably faster, whereas the duration of analgesia was longer in the diclofenac group (p < 0.05). In conclusion, dermal scarification could constitute an alternative method for treating renal colic as it is equally effective compared to the standard treatment of diclofenac sodium.
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Randomized Controlled Trial
Real-time ultrasound-guided PCNL using a novel SonixGPS needle tracking system.
SonixGPS is a successful ultrasound guidance position system. It helps to improve accuracy in performing complex puncture operations. This study firstly used SonixGPS to perform kidney calyx access in PCNL to investigate its effectiveness and safety. ⋯ Furthermore, the hemoglobin decrease was also obviously lower in the SonixGPS group than that in conventional US-guided group. SonixGPS needle tacking system guided PCNL is safe and effective in treating upper urinary tract stones. This novel technology makes puncturing more accuracy and can significantly decrease the incidence of relative hemorrhage and accelerate recovery.
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Randomized Controlled Trial
The effect of local anesthetic infiltration around nephrostomy tract on postoperative pain control after percutaneous nephrolithotomy.
The objective of the study was to investigate the effect of a long acting local anesthetic infiltration around nephrostomy tract on pain control after percutaneous nephrolithotomy. Forty-six patients with kidney stones of >2 cm undergoing single access subcostal percutaneous nephrolithotomy (PCNL) were enrolled in the study. Patients were randomized to levobupivacaine (Group I) and saline (Group II) infiltration groups. ⋯ Ambulation time and duration of nephrostomy tube were also similar. Infiltration of nephrostomy tract site with levobupivacaine does not have a superior effect compared to saline on postoperative pain control in patients undergoing PCNL. To prolong analgesia, the effect of intermittent tract injections or continuous infusion of local anesthetics for the postoperative maintenance of the local anesthetic effect seems worth to investigate in future studies.