The impact of general anesthesia on radiofrequency ablation of hepatocellular carcinoma

Kuo, Yuan-Hung; Chung, Kuan‐Chih; Hung, Chao‐Hung; Lu, Sheng–Nan; Wang, Jing‐Houng

doi:10.1016/j.kjms.2014.07.001

Cited by 16 publications

(15 citation statements)

References 28 publications

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“…It has been found that the type of anaesthesia has no effect on the survival of patients, but general anaesthesia is associated with a higher incidence of tumour recurrence [21]. For similar applications came Yuang-Hung et al by examining 118 patients [22].…”

Section: Discussionmentioning

confidence: 99%

WITHDRAWN: Thoracic blockade in percutaneous hepatocellular carcinoma.

Glinka

Braczkowska

Kowalczyk

et al. 2020

Preprint

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Background Hepatocellular carcinoma (HCC) is a primary liver tumor that generally develops in a marsh-altered liver. Local ablation using radio frequency waves is the first-line treatment for patients with early onset of this cancer who cannot undergo radical surgery. This is a painful procedure and must be performed under deep intravenous analgosedation or general anesthesia. The method that appears to meet the anesthesiological and surgical requirements is thoracic paravertebral block.Aim of the study The main purpose of the study was to determine the efficacy and safety of paravertebral block compared to local perioperative anesthesia in patients who had percutaneous thermoablation as a treatment for HHC.Methods 30 patients enrolled in the treatment of hepatocellular carcinoma by percutaneous thermoablation were enrolled in the study. Two groups of patients were compared: group PVBpatients under paravertebral block anesthesia, group BB -patients under local anesthesia, without paravertebral block. ResultsThe use of paravertebral blockade (PVB) did not significantly reduce the patient's concerns about the postoperative period, the ability to ask questions to the doctor, receive understandable information about anesthesia, reduce stress levels or increase the level of satisfaction with pain therapy in the postoperative period (p> 0.05). Patients significantly more often experienced pain during surgery without paravertebral block (p <0.001). Side effects of anesthesia occurred in both compared groups. They mainly concerned nausea and vomiting, which significantly more often occurred in the group without blockade (BB) and affected up to 60% of the respondents (p = 0.008).Significantly more often any painkillers were used among BB patients compared to PVB, respectively: immediately after surgery 53% vs 13% (p = 0.02), 1 hour after surgery 80% vs 27% (p = 0.003), 3h after surgery 80% vs 14% (p <0.001), 6h after surgery 60% vs 14% (p = 0.008), after 24h 47% vs 20% (p = 0.12). ConclusionsThe paravertebral block has proved to be a safe and well-tolerated and effective method of treating postoperative pain in patients with liver cancer treated by percutaneous thermoablation.Patients with PVB during the surgery and in the postoperative period had significantly less pain than HCC -Hepatocellular Carcinoma -hepatocellular carcinoma PEI -Percutaneous Ethanol Injection -percutaneous ethanol injection RA -Regional Anaesthesia -regional anesthesia RFA -Radiofrrequency Ablation -ablation using radio frequency waves PRFA -Percutaneus Radiofrrequency Ablation -transcutaneous ablation using radio frequency waves SBP -Systolic Blood Pressure SpO2 -Oxygen Saturation -oxygen saturation of arterial blood TPVB -Thoracic ParaVertebral Block -chest block Declarations Ethics Approval and Consent to Participate -all patients gave written consent for participation, in addition, Consent of the Bioethics Committee: Resolution No. 46/2017 of 9/11/2017 issued by the LG -collecting clinical materials; clinical material analysis; substantive supe...

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Section: Discussionmentioning

confidence: 99%

WITHDRAWN: Thoracic blockade in percutaneous hepatocellular carcinoma.

Glinka

Braczkowska

Kowalczyk

et al. 2020

Preprint

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“…However, the large dosage of remifentanil can easily cause respiratory depression. 4,5 Dezocine is a synthetic drug of the benzmorphan group, an agonist of -opioid receptors and an antagonist of -opioid receptors. It has moderate analgesic and sedative effects and is very safe without respiratory depression.…”

Section: Introductionmentioning

confidence: 99%

Effects of Dezocine-Remifentanil Intravenous Anaesthesia on Perioperative Signs, Serum TNF-α and IL-6 in Liver Cancer Patients undergoing Radiofrequency Ablation

Jia

Tian

Duan

et al. 2019

J Coll Physicians Surg Pak

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“…General anesthesia undoubtedly ensures better pain control than conscious sedation and reduces patient anxiety or panic, but it is not free of risks such as myocardial infarction, stroke, and malignant hyperthermia. [23] On the other hand, conscious sedation is more painful but does not require intubation, and several relative contraindications to general anesthesia such as impairment of lung function do not preclude its use. [1] Although most percutaneous ablations of renal tumors are currently performed under conscious sedation, there is a widespread belief that general anesthesia can ensure a better outcome.…”

Section: Discussionmentioning

confidence: 99%

Thermal Ablation of Renal Tumors under Ultrasound Guidance and Conscious Sedation: A Retrospective Experience

Sartori¹,

Tombesi²,

Bianchi³

et al. 2020

J Clin Res Radiol

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Purpose: Computed tomography (CT) guidance and general anesthesia have recently been recommended as the approach of choice for percutaneous ablation of small renal cell carcinoma (RCC), whereas ultrasound (US) guidance and conscious sedation have been tagged as inadequate. Aim of the study was to assess the safety and effectiveness of percutaneous thermal ablation of small RCC under ultrasound (US)-guidance and conscious sedation. Methods: The records of 74 patients with small RCC (≤5 cm), who underwent US-guided thermal ablation under conscious sedation were retrospectively reviewed. Conscious sedation was usually induced by means of intravenous bolus of midazolam 50-100 µg/kg plus continuous infusion of a 25 µg/mL solution of remifentanil at a rate of 0.05 µg/kg/min. Technical success, technical efficacy, local tumor progression (LTP), primary and secondary efficacy rates, complication rate, and 1-, 3-, and 5-year survival rates were analyzed. Results: No procedure needed to be converted to general anesthesia, and all tumors were treated according to the protocol, with a technical success of 100%. One patient died after surgical intervention for bowel perforation and other 2 patients experienced grade 3 complications. Mortality rate and major complication rate were 1.3% and 2.7%, respectively. One-month technical efficacy was 100%. LTP was observed in 4/74 patients, with a primary efficacy rate of 94.6%. Two of them underwent successful thermal ablation and secondary efficacy rate was, therefore, 97.3%. The median follow-up was 38 months (range 1-130 months). No patient died for tumor progression. 1-, 3-, and 5-year survival rates were 94%, 80.5%, and 60%, respectively. Conclusion: US guidance and conscious sedation remain valid alternatives to CT guidance and general anesthesia for the percutaneous ablation of small RCC.

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The impact of general anesthesia on radiofrequency ablation of hepatocellular carcinoma

Cited by 16 publications

References 28 publications

WITHDRAWN: Thoracic blockade in percutaneous hepatocellular carcinoma.

WITHDRAWN: Thoracic blockade in percutaneous hepatocellular carcinoma.

Effects of Dezocine-Remifentanil Intravenous Anaesthesia on Perioperative Signs, Serum TNF-α and IL-6 in Liver Cancer Patients undergoing Radiofrequency Ablation

Thermal Ablation of Renal Tumors under Ultrasound Guidance and Conscious Sedation: A Retrospective Experience

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