PAINLESS ESWL BY CUTANEOUS APPLICATION OF VASELINE

In a prospective study we investigated the efficacy of cutaneous vasel ine application in pain reduction during ESWL. In 150 patients (group 1) vaseline was applied on a skin area of 10 x 20 cm corresponding to the entry site of shock waves directly before ESWL was started. In 75 patients (group 2) ESWL was performed without vaseline. 10/150 (6.7%) in group 1 and 27/75 (36.4%) in group 2 (p < 0.001) needed additional analgesic sedation. Requirement for supplementary analgosedation was m ost pronounced for patients with lower calyceal and distal ureteral st ones [20% and 19% in group 1; 53% and 78% in group 2 (p < 0.03)]. The median pain score in group 1 was 2.5 +/- 1.05, in group 2 4.25 +/- 1.1 3 (p < 0.05). Local vaseline application significantly reduced pain du ring ESWL independent from stone location. Because of its high viscosi ty vaseline inhibited the development of cavitation bubbles at the ski n surface. Cutaneous vaseline application reducing the need for analge sic sedation might especially be useful in outpatient ESWL procedures.