The Factors of Pain and Pain Management after Transarterial Chemoembolization in Patients with Hepatocellular Carcinoma

Abstract

연구의 필요성간세포암은Purpose: The purpose of this study was to identify the factors of pain and pain management after transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). Methods: Participants were 99 inpatients with HCC who underwent TACE at C University in Seoul from May to October 2016. The instruments used in this study were the Numerical Rating Scale (NRS), the Pain Management Index (PMI), and the modified Patient Outcome Questionnaire (American Pain Society). The data were analyzed using SPSS 24.0, specifically descriptive statistics, t-test, ANOVA, and multiple regression. Results: The percentage of patients who experienced pain after TACE was 66.7%. The mean pain score immediately after TACE was 4.43±2.36 and the highest score on average was 6.58±2.32. The pain score was highest at 5.24±5.67 hours after TACE. Significant factors influencing pain after TACE were the extent of embolization and the ECOG (Eastern Cooperative Oncology Group) score, which explained 26% of the variance in pain. PMI scores revealed that 33.3% of the participants were inadequately treated for pain. Conclusion: In order to properly manage pain after TACE, medical staff need accurate understanding of pain and to administer the appropriate dosage of analgesics. The development of pain management protocol for patients who have undergone TACE would help achieve these goals.

Phenylboronic Acid Conjugated to Doxorubicin for the Treatment of Hepatocellular Carcinoma Through Transcatheter Arterial Chemoembolization

“…According to the BCLC guidelines, many HCC patients attempt LRT as the primary treatment method, and 40% of HCC patients attempt TACE as their primary treatment (21). However, there is a signi cant difference in tumor burden and liver function depending on the patient, making it di cult to achieve the same effect through TACE.…”

Efficacy of Intra-Arterial Lidocaine for Pain Control Resulting From Transarterial Chemoembolization of Hepatocellular Carcinoma

“…In a study by coldwell et al excellent analgesia during hepatic TACE was achieved with a celiac plexus block. However, this method seems to be risky and time-consuming 15 . Intra-arterial lidocaine administration during TACE has been known not only for reduction of severity of the pain that is associated with TACE but facilitates faster recovery as well 11,12 .…”