THE EFFICACY OF PIROXICAM/LIDOCAINE/CYCLOBENZAPRINE
HYDROCHLORIDE TOPICAL GEL IN THE PAIN MANAGEMENT
DURING EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY (ESWL)
CĂTĂLIN PRICOP1,2, IRINA NEGRU1,2, CĂTĂLIN CIUTĂ2, VIOREL JINGA3,4, ADRIANA ILIEȘIU4*, IONEL ALEXANDRU CHECHERIȚĂ3,5, LIVIU TODOSI1,2, DANIEL RADAVOI3,4, MARIANA JINGA5
1Departament of Surgery – Urology, “Grigore T. Popa” University of Medicine and Pharmacy Iași, 16 Universitatii Street,
700115, Iași, Romania
2Department of Urology, “Dr. C. I. Parhon” Clinical Hospital, 50 Carol I Bulevard, 700503, Iași, Romania
3Clinical Department No. 3, “Carol Davila” University of Medicine and Pharmacy Bucharest, 37 Dionisie Lupu Street,
020022, Bucharest, Romania
4Department of Urology 3, “Prof. Dr. Theodor Burghele” Urology Clinical Hospital, 20 Panduri Road, 050659, Bucharest,
Romania
5Department of Nephrology and Dialysis, “Sf. Ioan” Emergency Clinical Hospital, 13 Vitan-Bârzești Road, 042122,
Bucharest, Romania
4Department of Internal Medicine and Cardiology, “Prof. Dr. Theodor Burghele” Urology Clinical Hospital, 20 Panduri
Road, 050659, Bucharest, Romania
5Central University Emergency Military Hospital “Carol Davila”, 88 Calea Plevnei Str., 010825, Bucharest, Romania
*corresponding author: adilies@yahoo.com
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Abstract:
The aim of the study was to evaluate the efficacy of the combination for cutaneous application of
piroxicam/lidocaine/cyclobenzaprine hydrochloride for the pain management during Extracorporeal Shock Wave Lithotripsy
(ESWL). A number of 256 patients with renal and ureteral stones were randomly assigned to one of the 3 groups: group A
(topical analgesic 30 minutes prior to ESWL), group B (topical analgesic 60 minutes prior to ESWL) and group C (no
treatment prior the ESWL). The pain before and during the procedure was evaluated with a Visual Analogue Scale (VAS)
and for each patient the rescue analgesic medication was quantified. Regarding age, weight, stone size, number of shock
wave delivered and maximum voltage used, no statistical differences were noticed in the three groups (p > 0.05). The topical
application of a gel with this analgetic combination before the ESWL provided significant relief of the pain during this
procedure in comparison with no treatment. The topical analgesic before lithotripsy also reduced the need of rescue
medication. The gel with piroxicam/lidocaine/cyclobenzaprine hydrochloride is a valuable alternative for the management of
pain during ESWL.






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