In a prospective study we investigated the efficacy of cutaneous
vaseline 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 most pronounced for patients with lower calyceal and distal ureteral stones [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 +/- 1.13 (p < 0.05). Local
vaseline application significantly reduced
pain during ESWL independent from stone location. Because of its high viscosity
vaseline inhibited the development of cavitation bubbles at the skin surface. Cutaneous
vaseline application reducing the need for
analgesic sedation might especially be useful in outpatient ESWL procedures.