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Saraogi M. et al., 2020: Role of Complementary Medicine (Music, Acupuncture, Acupressure, TENS and Audio-Visual Distraction) in Shockwave Lithotripsy (SWL): A Systematic Review From EAU Sections of Urolithiasis (EULIS) and Uro-Technology (ESUT)

Saraogi M, Geraghty RM, Hameed B, Rob S, Pietropaolo A, Sarica K, Gozen A, Liatsikos E, Somani BK.
Faculty of Life and Environmental Sciences, University of Southampton, United Kindom.
Department of Urology, University hospital Newcastle, United Kindom.
Department of Urology, Kasturba Medical College Manipal, Manipal Academy of Higher Education (MAHE), Karnataka, India.
Department of Urology, University Hospital Southampton NHS Trust, United Kindom.
Department of Urology, Biruni University Medical School, Istanbul, Turkey.
Department of Urology, Klinikum Heilbronn, Heilbronn, Germany.
Department of Urology, University of Patras, Patras, Greece.
Department of Urology, University Hospital Southampton NHS Trust, United Kindom.

Abstract

We performed a systematic review to look at the role of alternative or complementary medicine such as music, acupressure, acupuncture, transcutaneous electrical nerve stimulation (TENS) and audiovisual distractions to decrease analgesia requirement and alleviate anxiety during SWL. Twenty-three papers(2439 participants) were included: Music (n = 1056.6%), Acupuncture (n = 517.7%), Acupressure (n = 13.8%), TENS (n = 617.2%), and audiovisual distraction (n = 14.6%). Most of the studies showed that complementary therapy, lowered pain, and anxiety with higher patient satisfaction and willingness to undergo the procedure. With its feasibility and convenience, urological guidelines need to endorse it, and more should be done to promote its use in outpatient urological procedures.
Urology. 2020 Nov;145:38-51. doi: 10.1016/j.urology.2020.06.035. Epub 2020 Jul 5. PMID: 32640263

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Commenti 1

Hans-Göran Tiselius il Venerdì, 05 Febbraio 2021 08:30

Despite the technical development of lithotripter technology, it is important to know that efficient SWL is painful and requires some kind of measures to reduce pain experience and make the patients feel comfortable.

This article is a detailed analysis of different complementary methods with the aim of completing the treatment in an optimal way. It is necessary both to treat pain and reduce anxiety. When we in Sweden started successful SWL (with the Dornier HM3 device) with only analgesics and sedatives, I was personally invited to demonstrate this technique in a department abroad. This attempt failed mainly because the patient had pronounced anxiety. The lesson learnt was that without a comfortable patient, SWL with only analgesics and sedatives is less likely to be successful.

The authors of this article looked at the effect of:
Music in 10 reports
Acopuncture in 5 reports
Acupressure in 1 report
TENS in 6 reports
Audiovisual distraction in 1 report.

The literature data in terms of treatment result, pain and anxiety is summarized in two extensive tables.

It is of note that when music was combined with noise cancelling head-phones it was possible to apply more shockwaves with higher energy than was the case without this method.
The authors’ major conclusion from the meta-analysis was that music reduced anxiety but not pain and moreover, that TENS did not reduce pain significantly. The overall effect was, however, reduced requirement of analgesics because both pain and anxiety were decreased.

Most importantly the complementary methods increased patients’ willingness to repeat SWL!
The reduced need of analgesics and sedatives increased patients’ satisfaction and it is emphasized that complementary medicine methods should be more commonly applied during SWL. My personal interpretation of this article is that music with noise reducing head-phones is an ideal auxiliary device. Early experience from my own unit showed that it is important for patients to choose their own music.

Hans-Göran Tiselius

Despite the technical development of lithotripter technology, it is important to know that efficient SWL is painful and requires some kind of measures to reduce pain experience and make the patients feel comfortable. This article is a detailed analysis of different complementary methods with the aim of completing the treatment in an optimal way. It is necessary both to treat pain and reduce anxiety. When we in Sweden started successful SWL (with the Dornier HM3 device) with only analgesics and sedatives, I was personally invited to demonstrate this technique in a department abroad. This attempt failed mainly because the patient had pronounced anxiety. The lesson learnt was that without a comfortable patient, SWL with only analgesics and sedatives is less likely to be successful. The authors of this article looked at the effect of: Music in 10 reports Acopuncture in 5 reports Acupressure in 1 report TENS in 6 reports Audiovisual distraction in 1 report. The literature data in terms of treatment result, pain and anxiety is summarized in two extensive tables. It is of note that when music was combined with noise cancelling head-phones it was possible to apply more shockwaves with higher energy than was the case without this method. The authors’ major conclusion from the meta-analysis was that music reduced anxiety but not pain and moreover, that TENS did not reduce pain significantly. The overall effect was, however, reduced requirement of analgesics because both pain and anxiety were decreased. Most importantly the complementary methods increased patients’ willingness to repeat SWL! The reduced need of analgesics and sedatives increased patients’ satisfaction and it is emphasized that complementary medicine methods should be more commonly applied during SWL. My personal interpretation of this article is that music with noise reducing head-phones is an ideal auxiliary device. Early experience from my own unit showed that it is important for patients to choose their own music. Hans-Göran Tiselius
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Lunedì, 19 Aprile 2021

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