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Hepatic hilar and celiac plexus nerve blocks as analgesia for doxorubicin-eluting bead embolization procedures for hepatocellular carcinoma: A non-blinded randomized clinical trial.
Faculty
Medicine
Year:
2021
Type of Publication:
ZU Hosted
Pages:
Authors:
Ahmed Awad Abdelaziz Bisar
Staff Zu Site
Abstract In Staff Site
Journal:
Journal of Vascular and Interventional Radiology Elsevier
Volume:
Keywords :
Hepatic hilar , celiac plexus nerve blocks
Abstract:
Abstract Purpose: To investigate whether hepatic hilar and celiac plexus nerve blocks provide safe and effective analgesia to patients undergoing doxorubicin-eluting embolics transarterial chemoembolization (DEE-TACE) for hepatocellular carcinoma. Materials and methods: In this prospective, randomized trial, 92 patients undergoing DEE-TACE for hepatocellular carcinoma were enrolled. The control group received standard intraprocedural local anesthetic, intra-arterial lidocaine, and intravenous analgesia; the study group underwent additional hepatic hilar and celiac plexus nerve blocks. Intra-arterial lidocaine, intravenous and oral narcotic and antiemetic requirements after the procedure, pain, patient satisfaction, adverse events, and hospital stay were compared. Results: The nerve block group reported less pain during and after the procedure at days 1 and 7 (P < .001), although differences resolved by week 2. The control group received more intra-arterial lidocaine (P < .001) and required approximately double the amount of narcotic analgesia during and after the procedure, extending to 3 weeks after the procedure (P < .001), as well as less antiemetics (P < .001). No differences in adverse events, hospital stay, and overall patient satisfaction were noted. Conclusions: Hepatic hilar and celiac plexus nerve blocks before procedures can result in lower pain during and after procedures in patients undergoing DEE-TACE. Furthermore, nerve blocks result in lower opioid consumption and opioid-related complications for 3 weeks following procedures. Keywords: Celiac block; Chemoembolization; doxorubicin-eluting beads; hepatocellular carcinoma; transarterial.
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