Use of pethidine for percutaneous liver biopsy – a randomised, placebo-controlled, double blind study

Abstract

BackgroundPercutaneous liver biopsy (PLB) is the “gold standard” in the diagnosis of liver diseases. A pilot trial has shown pethidine may reduce anxiety and the need for post-procedural pain relief. The aim of this study was to investigate the role of pre-procedural pethidine.MethodsA double-blinded, randomized, placebo-controlled trial was conducted to assess the need for pethidine prior to PLB. 98 patients were randomly assigned to receive either 50 mg pethidine i.v. (n = 48), or an equal volume of 0.9% normal saline (n = 50). PLB was performed with ultrasound guidance after adequate local anaesthesia with xylocaine. Patients were asked to self-evaluate pain experienced using a visual analogue score (0–10) immediately and an hour after PLB. Patients were then followed up 24 hours after the procedure to assess their pain score, retrospective pain score and willingness to have a repeat procedure.ResultsPethidine administration resulted in significantly lower pain scores (0.60 ± 0.1 vs 1.2 ± 0.2, p = 0.006) and required less analgesia (0% vs 10%, p = 0.03) immediately after PLB in comparison to the placebo group. There was no significant difference in the pain score and analgesia requirement one hour after the procedure, the pain score at 24 hours after procedure and retrospective pain score. 94% of all patients of either group are willing to under go a repeat liver biopsy (NS).ConclusionsThe administration of pethidine routinely prior to PLB reduces the immediate post procedural pain but has no lasting effect and does not influence the patients’ decision making process for future investigations.Trial registrationACTRN12614001194651, 13 November 2014

Incidence of Complications from Percutaneous Biopsy in Chronic Liver Disease: A Systematic Review and Meta-Analysis

“…Experience not reported AE, deaths, SAE Monitored for 1–4 h, with 24 h follow-up phone call. [solicited] Pan (2015), New Zealand, Single center [ 52 ] RCT; 2009–2011; Consecutive patients 61.2% Viral; 39% other (non-focal) Mean age 42–52 years; 70% male; Mean BMI 28 kg/m 2 US-guided, percussion-assisted percutaneous Included: INR < 1.5 and platelet count > 50*10^9/L. Local anesthesia (1% xylocaine containing 1:100,000 adrenaline).…”

D&C operasyonlarında sedoanaljezi için propofol ile kullanılan farklı opioidlerin karşılaştırılması

“…Doğan ve arkadaşları perkutan karaciğer biyopsisi uyguladıkları hastalarda sedasyon amacıyla kullandıkları petidinin güvenli bir analjezik olduğunu bildirmişlerdir (28). Ayrıca petidinin perkutan karaciğer biyopsisi öncesi uygulandığı bir başka çalışmada yan etkisi ve komplikasyonlar açısından kontrol grubundan farklı olmadığı bildirilmiştir (30). Bizim çalışmamızda petidin de dahil hiçbir grupta herhangi bir yan etki ve komplikasyona rastlanmamıştır.…”