Chemoembolization for hepatocellular carcinoma: Effect of intraarterial lidocaine in peri- and post-procedural pain and hospitalization(116 visite) Romano M, Giojelli A, Tamburrini O, Salvatore M
Radiol Med (ISSN: 0033-8362, 1826-6983, 1826-6983electronic), 2003 Apr; 105(4): 350-355.
Tipo di articolo: Journal Article,
Impact factor: 1.368, Impact factor a 5 anni: 1.47
Parole chiave: Anaesthetics, Local Administration And Dosage, Hepatocellular Carcinoma, Liver Neoplasms, Chemoembolization, Cisplatin, Epirubicin, Gelfoam, Iodinated Poppyseed Oil, Lidocaine, Narcotic Analgesic Agent, Sodium Chloride, Tramadol, Adult, Article, Artificial Embolism, Blood Flow, Clinical Article, Controlled Study, Drug Safety, Emulsion, Female, Fever, Hepatic Artery, Hospitalization, Human, Liver Cell Carcinoma, Nausea And Vomiting, Pain Assessment, Post Embolization Syndrome, Side Effect, Statistical Significance, Visual Analog Scale, Abdominal Pain, Anesthetics, Therapeutic, Chi-Square Distribution, Injections, Intra-Arterial, Length Of Stay, Middle Aged, Pain Measurement, Treatment Outcome,
Affiliazioni:
*** IBB - CNR *** Dipto. Assistenziale Radiol./R., Universita Federico II, Napoli, Italy Ist. di Biostrutture e Bioimmagini, Consiglio Nazionale delle Ricerche, Napoli, Italy Unità Operativa di Radiologia, Universita Magna Graecia, Catanzaro, Italy Via Luca da Penne, 3, 80122 Napoli NA, Italy Unit Operativa di Radiologia, Universita Magna Graecia, Catanzaro, Italy
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Purpose. To assess the efficacy of intraarterial lidocaine on peri- and post-procedural pain and on length of hospital stay in hepatocellular carcinoma (HCC) patients undergoing chemoembolization. Materials and methods. Twenty-eight patients (19M, 9F, age range 49-76) who underwent hepatic chemoembolization at our Institution between March 2000 and February 2002 were included in the study. Group A consisted of 14 patients who received intraarterial lidocaine immediately before and during chemoembolization, while in the 14 patients of group B lidocaine was substituted with saline solution. The doses of centrally acting narcotics (tramadol) administered periprocedurally and in the three days following the procedure were compared, as were the hospitalization times. Subjective pain was measured using the visual analogue scale. Chemoembolizations were performed with an emulsion of lipiodol, cisplatin and epirubicin followed by embolizing material (gelfoam of Contour particles) in order to achieve complete blood flow stop in the proper hepatic artery. Results. No side effects were noted that could be due to systemic administration of lidocaine. All patients experienced some degree of post-embolization syndrome. Periprocedural, day 1 and day 2 post chemoembolization dosages of tramadol were significantly lower in group A with respect to group B patients. No group A patient required analgesia on day 3. No statistical difference was observed in time persistence of nausea and vomiting, fever and hospitalization time between the two patient groups. Conclusions. Intraarterial administration of lidocaine before and during chemoembolization is a safe and effective method for preventing or reducing peri- and post-procedural pain and dosage of narcotic analgesics in patients with HCC. Hospitalization times did not differ significantly between the two groups, probably because of the other components of post-embolization syndrome, such as fever, nausea and vomiting.
59 Records (56 escludendo Abstract e Conferenze). Impact factor totale: 200.405 (191.496 escludendo Abstract e Conferenze). Impact factor a 5 anni totale: 210.527 (201.042 escludendo Abstract e Conferenze).
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