M Cheung Ning1, M K Karmakar. 1. Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, People's Republic of China. cheungning2@gmail.com
Abstract
OBJECTIVES: Percutaneous radiofrequency ablation (PRFA) of liver tumours performed under local anaesthesia and intravenous sedation can cause severe pain to patients. This prospective study evaluated the efficacy of a right thoracic paravertebral block (TPVB) for anaesthesia and analgesia during PRFA of liver tumours. METHODS: 20 patients, aged 44-74 years, with liver malignancies received a multiple injection TPVB at the T6-10 levels 30 min before the PRFA. An intravenous infusion of propofol (3-5 mg kg(-1) h(-1)) was administered to patients who requested to be sedated and intravenous fentanyl (25 µg bolus) was administered as rescue analgesia. Pain during the TPVB and PRFA was assessed using a numerical rating scale (NRS; 0, no pain; 10, worst imaginable pain). Patients were also assessed for residual pain and analgesic consumption during the 24 h after the intervention. RESULTS: The TPVB was well tolerated and produced ipsilateral sensory anaesthesia with satisfactory spread (median (range); 8 (6-11) dermatomes). The PRFA procedure caused mild pain (mean (standard deviation, SD); NRS 1.4 (1.9)) during the insertion of the ablation needle and the peak pain intensity during the therapeutic burn was moderate (mean (SD); NRS 5.0 (3.3)) in severity. During the 24 h after the PRFA, patients reported minimal pain and consumed very few analgesics. The mean (SD) satisfaction score (0, totally dissatisfied; 10, very satisfied) of the patients was 8.9 (1.1) and that of the radiologists was 8.8 (1.4). CONCLUSION: A right TPVB is safe and effective for anaesthesia and analgesia during PRFA of malignant liver tumours.
OBJECTIVES: Percutaneous radiofrequency ablation (PRFA) of liver tumours performed under local anaesthesia and intravenous sedation can cause severe pain to patients. This prospective study evaluated the efficacy of a right thoracic paravertebral block (TPVB) for anaesthesia and analgesia during PRFA of liver tumours. METHODS: 20 patients, aged 44-74 years, with liver malignancies received a multiple injection TPVB at the T6-10 levels 30 min before the PRFA. An intravenous infusion of propofol (3-5 mg kg(-1) h(-1)) was administered to patients who requested to be sedated and intravenous fentanyl (25 µg bolus) was administered as rescue analgesia. Pain during the TPVB and PRFA was assessed using a numerical rating scale (NRS; 0, no pain; 10, worst imaginable pain). Patients were also assessed for residual pain and analgesic consumption during the 24 h after the intervention. RESULTS: The TPVB was well tolerated and produced ipsilateral sensory anaesthesia with satisfactory spread (median (range); 8 (6-11) dermatomes). The PRFA procedure caused mild pain (mean (standard deviation, SD); NRS 1.4 (1.9)) during the insertion of the ablation needle and the peak pain intensity during the therapeutic burn was moderate (mean (SD); NRS 5.0 (3.3)) in severity. During the 24 h after the PRFA, patients reported minimal pain and consumed very few analgesics. The mean (SD) satisfaction score (0, totally dissatisfied; 10, very satisfied) of the patients was 8.9 (1.1) and that of the radiologists was 8.8 (1.4). CONCLUSION: A right TPVB is safe and effective for anaesthesia and analgesia during PRFA of malignant liver tumours.
Authors: Manoj K Karmakar; Lester A H Critchley; Anthony M-H Ho; Tony Gin; Tak Wai Lee; Anthony P C Yim Journal: Chest Date: 2003-02 Impact factor: 9.410
Authors: Tito Livraghi; Luigi Solbiati; M Franca Meloni; G Scott Gazelle; Elkan F Halpern; S Nahum Goldberg Journal: Radiology Date: 2003-02 Impact factor: 11.105
Authors: Carlo Gazzera; Paolo Fonio; Riccardo Faletti; Maria Chiara Dotto; Fabio Gobbi; Pierpaolo Donadio; Giovanni Gandini Journal: Radiol Med Date: 2014-01-10 Impact factor: 3.469