Hepatic chemoembolization: Effect of intraarterial lidocaine on pain and postprocedure recovery

Hartnell, George G.; Gates, Julia; Stuart, Keith; Underhill, Jonathan; Brophy, David P.

doi:10.1007/s002709900391

Cited by 28 publications

(18 citation statements)

References 12 publications

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“…Four studies 19Y22 reported statistically significant decreases in frequency and dose for both procedural and postprocedural analgesia requirements when using IA lidocaine. Two studies 19,22 However, both studies reported low incidences of grades 2 and 3 RUQP after TACE, and although IA lidocaine was included in the preprocedure medication regimen and may have contributed to RUQP management, these findings must be interpreted with caution as multiple interventions were implemented, and neither study attributes their findings to pre-TACE IA lidocaine alone. It must also be noted that only 3 studies 20Y22 used a visual analog scale as a subjective measurement of pain.…”

Section: Intra-arterial Lidocainementioning

confidence: 96%

Management of Postembolization Syndrome Following Hepatic Transarterial Chemoembolization for Primary or Metastatic Liver Cancer

Blackburn¹,

West²

2016

Cancer Nurs

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Section: Intra-arterial Lidocainementioning

confidence: 96%

Management of Postembolization Syndrome Following Hepatic Transarterial Chemoembolization for Primary or Metastatic Liver Cancer

Blackburn¹,

West²

2016

Cancer Nurs

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“…Selective and superselective injections were performed as necessary and injections were always performed distal to the origin of the gastroduodenal artery. Before chemoembolization, 20 mg lidocaine was administered intra-arterially to reduce pain and discomfort during chemoembolization [9]. Chemoembolization was then performed with a mixture of 20–40 mg doxorubicin (Adriamycin) emulsified with 5 ml of iodized oil (lipiodol) and 1–2 ml of water-soluble iodinated contrast agent (Solutrast).…”

Section: Methodsmentioning

confidence: 99%

Transarterial Chemoembolization of Advanced Liver Metastases of Neuroendocrine Tumors – A Retrospective Single-Center Analysis

Kress¹,

Wagner²,

Wied

et al. 2003

Digestion

139

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Background: In neuroendocrine tumors, metastases are a negative prognostic factor for survival and quality of life. Transcatheter arterial chemoembolization (TACE) is thought to be an effective symptomatic and antiproliferative treatment in patients with otherwise progressive disease. Methods: 62 chemoembolization procedures in 26 patients with progressive neuroendocrine tumors were reviewed. The underlying disease was carcinoid syndrome in 10, non-functional midgut tumor in 2, non-functional pancreatic tumor in 7, malignant insulinoma in 2 patients, non-functional tumor of the stomach in 1 and of unknown origin in 4 patients. Tumor burden of the liver was <25% in 3, 25–50% in 11, 50–75% in 6 and >75% in 6 patients. Results: TACE was technically successful in 57 cases. Four patients developed minor and 5 major complications. The 30-day mortality rate was 7.7%. According to WHO criteria, 14 patients had no change in tumor burden, 2 had regression and 5 progress after chemoembolization. Patients with a tumor burden >75% of the liver did not benefit from TACE due to the development of major complications, whereas patients with low (<50%) tumor burden and high (>50%) lipiodol uptake showed a trend towards longer survival. Five-year survival time after diagnosis was 48%. Patients treated with octreotide and/or α-interferon had no benefit from chemoembolization with regard to their carcinoid syndrome. Conclusions: In this retrospective study, patients with low (<50%) tumor burden and high (>50%) lipiodol uptake responded better to TACE than end-stage patients.

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“…Intra-arterial injection of lidocaine has been reported to reduce the severity and duration of postembolization pain. 18,19 The usage of corticosteroids to reduce post-embolization pain has been shown to be none beneficial. 19 In our experience, the usage of intravenous analgesics during the procedure and oral analgesics such as Metamizole (Ratiopharm, Ulm, Germany) provide sufficient pain control after chemoembolization.…”

Section: Current Trends In Interventional Treatment Of Colorectal Canmentioning

confidence: 99%

“…The DEBIRI is composed of microspheres that bind irinotecan and release the drug for a period of time after injection at the tumour side. 18 The use of drug-eluting beads results in a lower peak plasma concentration of the chemotherapeutic drugs compared with traditional TACE and longer exposure of the tumour to the therapeutic agents. The lower peak concentration results in lower exposure of healthy liver tissue.…”

Section: Current Trends In Interventional Treatment Of Colorectal Canmentioning

confidence: 99%

Current strategies in interventional oncology of colorectal liver metastases

Gruber‐Rouh

Marko

Thalhammer

et al. 2016

BJR

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The adequate treatment of non-resectable liver metastases from colorectal cancer which are resistant to systemic chemotherapy currently provides a great challenge. The aim is to identify and review key strategies in the treatment of colorectal liver metastases. A search for current literature on the topic of interventional strategies for colorectal metastases was performed in Medline in order to achieve this goal. Studies before 2005 and with ,20 patients treated for colorectal metastases were excluded. Transarterial chemoembolization (TACE), transarterial embolization and selective internal radiation therapy (SIRT) were identified as examples of regional strategies for colorectal liver metastases, utilizing the unique blood supply of the liver. Radiofrequency ablation (RFA), microwave ablation (MWA) and cryoablation were selected as examples for currently available ablative techniques. Median survival in the key studies reviewed ranged from 7.7 to 28.6 for TACE, 8.3-12.6 for SIRT, 8.2-53.2 for RFA and 29-43 months for MWA. After review of the literature, it can be concluded that interventional oncologic therapies are a safe and effective method for treating colorectal liver metastases. The use of new chemotherapeutic agents for local therapy and new ablation technologies and techniques may increase patient survival and allows a neoadjuvant therapy setting. In addition, a combination of local therapies may be used to increase effectiveness in the future, which is subject to further research. INTRODUCTIONColorectal cancer is one of the most common cancers that shows fatal progression.1 Colorectal carcinoma most commonly metastasises to the liver due to haematogenous spread.2 At the time of diagnosis, 20-30% of patients have liver metastases, and during the course of disease, up to 60% of patients develop hepatic metastases.3 Although surgical excision is the first-line treatment for colorectal metastases, only 10-25% of patients are candidates for surgical resection. 4 Neoadjuvant systemic chemotherapy only allows 10-30% of patients with unresectable colorectal liver metastases sufficient downsizing for resection.

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Hepatic chemoembolization: Effect of intraarterial lidocaine on pain and postprocedure recovery

Abstract: Intraarterial lidocaine during chemoembolization reduces the severity and duration of pain after chemoembolization resulting in faster recovery thus reducing the length of hospitalization.

Cited by 28 publications

References 12 publications

Management of Postembolization Syndrome Following Hepatic Transarterial Chemoembolization for Primary or Metastatic Liver Cancer

Management of Postembolization Syndrome Following Hepatic Transarterial Chemoembolization for Primary or Metastatic Liver Cancer

Transarterial Chemoembolization of Advanced Liver Metastases of Neuroendocrine Tumors – A Retrospective Single-Center Analysis

Current strategies in interventional oncology of colorectal liver metastases

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