Image not available

Acar A et al, 2013: The Effect of EMLA Cream on Patient-Controlled Analgesia with Remifentanil in ESWL Procedure: A Placebo-Controlled Randomized Study

Acar A, Erhan E, Nuri Deniz M, Ugur G
Department of Anaesthesiology and Reanimation, School of Medicine, Ege University, Izmir, Turkey


Abstract

BACKGROUND: To alleviate stinging pain in the skin entry area and visceral discomfort in patients who are undergoing ESWL.

OBJECTIVES: This study was designed to investigate the effectiveness of the EMLA cream in combination with remifentanil patient-controlled analgesia (PCA) in patients undergoing ESWL treatment.

PATIENTS AND METHODS: Sixty patients were divided into two double-blind randomized groups. Those in the first group were administered 3-5mm of EMLA 5% cream on a marked area; the second group received, as a placebo, a cream with no analgesic effect in the same amount. All patients were administered a remifentanil bolus with a PCA device. Arterial blood pressure, oxygen saturation, and respiratory rate were recorded throughout the procedure; postoperative side effects, agitation, and respiratory depression were measured after. Visual Analogue Scale (VAS) scores were taken preoperatively, perioperatively, directly postoperatively, and 60 minutes subsequent to finishing the procedure.

RESULTS: There were no statistically significant differences in the frequency of PCA demands and delivered boluses or among perioperative VAS. No significant side effects were noted. Patient satisfaction was recorded high in both groups.

CONCLUSIONS: EMLA cream offered no advantage over the placebo cream in patients undergoing ESWL with remifentanil PCA.

Anesth Pain Med. 2013 Winter;2(3):119-22. doi: 10.5812/aapm.7790. Epub 2013 Jan 1.
PMID:24244921 [PubMed]
PMCID:PMC3821126

Rate this blog entry:
0
 

Comments 1

Hans-Göran Tiselius on Wednesday, 27 November 2013 09:05

The authors studied the possible effect of EMLA cream application as a complement to remifentanil during SWL. The conclusion was that EMLA did not offer any advantage. The reason for that is probably that the major pain component during SWL does not come from the skin but is visceral. My own experience is that with a low-power SWL some positive effect can be noted, but this effect disappears when a higher shockwave power, necessary for stone disintegration, is used.

Hans-Göran Tiselius

The authors studied the possible effect of EMLA cream application as a complement to remifentanil during SWL. The conclusion was that EMLA did not offer any advantage. The reason for that is probably that the major pain component during SWL does not come from the skin but is visceral. My own experience is that with a low-power SWL some positive effect can be noted, but this effect disappears when a higher shockwave power, necessary for stone disintegration, is used. Hans-Göran Tiselius
Guest
Friday, 28 July 2017
STORZ MEDICAL AG
Lohstampfestrasse 8
8274 Tägerwilen
Switzerland
Tel.: +41 (0)71 677 45 45
Fax: +41 (0)71 677 45 05

www.storzmedical.com
Personal data
Address
Contact data
Message