Hepatic chemoembolization: Effect of intraarterial lidocaine on pain and postprocedure recovery
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Purpose: To determine if intraarterial lidocaine reduces pain during and after chemoembolization, and whether it influences postprocedure recovery.
Methods: Two patient cohorts undergoing selective hepatic chemoembolization were compared. Chemoembolization was performed without lidocaine (control group) in 27 patients and intraarterial lidocaine was used (lidocaine group) in 29 similar patients. Objective changes in patient management were assessed. Pain reduction in 31 more procedures with lidocaine (total 60) was assessed and related to tumor type.
Results: During chemoembolization, intraarterial lidocaine reduced the need for additional intravenous analgesics from 69% to 19%. After chemoembolization the mean Dilaudid dose in the first 24 hr was reduced from 9.5 mg to 4.15 mg; accordingly, the mean length of hospital stay was reduced from 67.5 to 53.5 hr. During the day of chemoembolization, the mean oral fluid intake increased from 420 ml (control group) to 487 ml (lidocaine group); the percentage of patients taking solid food on the day of chemoembolization increased from 3% to 43%.
Conclusion: Intraarterial lidocaine during chemoembolization reduces the severity and duration of pain after chemoembolization resulting in faster recovery thus reducing the length of hospitalization.
Key wordsAnesthesia Chemotherapy, complications Embolism, therapeutic Hepatic arteries, therapeutic blockade Liver neoplasms, chemotherapeutic infusion
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- 8.Daniels J, Pentecost M, Teitelbaum G, Stanley P (1992) Hepatic artery chemoembolization for carcinoma of colon using angiostat collagen and cisplatin, mitomycin and doxorubicin: Response, survival and serum drug levels. Proc Ann Meet Am Soc Clin Oncol 11:A497Google Scholar
- 11.Farinati F, De Maria N, Marafin C, Herszenyi L, Del Prato S, Rinaldi M, Perini L, Cardin R, Naccarato R (1996) Unresectable hepatocellular carcinoma in cirrhosis: Survival, prognostic factors, and unexpected side effects after transcatheter arterial chemoembolization. Dig Dis Sei 41:2332–2339CrossRefGoogle Scholar
- 15.Essentials of ACLS (1994) In: Cummins RO (ed) Advanced Cardiac Life Support. American Heart Association, pp 1–18Google Scholar
- 16.Novak D (1990) Complications of arterial embolization. In: Dondelinger RF (ed) Interventional Radiology, Thieme, Stuttgart, pp 314–324Google Scholar