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[Analgesia using oral administration of tilidine naloxone for extracorporeal shockwave lithotripsy. A double blind study]

Author(s): Hankemeier U, Herberhold D, Graff J

Affiliation(s): Klinik fur Anasthesiologie und operative Intensivmedizin, Ruhr-Universitat Bochum.

Publication date & source: 1991-05, Anasthesiol Intensivmed Notfallmed Schmerzther., 26(3):143-7.

Publication type: Clinical Trial; Randomized Controlled Trial

Reduction in pain perception during ESWL due to a technical modification of the lithotriptor was expected and prompted a reassessment of anaesthesia techniques for ESWL. In this study the need for analgesic treatment had to be investigated. After satisfactory preliminary results in a previous pilot study, the value of the oral combination of the anti-anxiety drug dipotassium clorazepate on the evening before ESWL together with the analgesic tilidine-naloxone before treatment was tested in a randomised double-blind study in 120 patients. In case of intolerable pain during the treatment all patients were free to ask for additional intravenous analgesic medication (fentanyl). During ESWL, 28.3% of the tilidine-N group patients and 6.7% of the placebo group were pain-free, whereas intolerable pain was reported by 30% of the tilidine-N group and 56.7% of the placebo group. Therefore, 70% of the tilidine-N group patients were treated without any additional analgesic or sedative medication. The good experience with this oral anaesthesia approach, the lack of significant side effects and a good acceptance by the patients warrant further recommendation of this technique.

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