Efficacy and Safety of Deep Sedation in Percutaneous Radiofrequency Ablation for Hepatocellular Carcinoma
Radiofrequency ablation (RFA) has been accepted as safe and effective for treating early-stage hepatocellular carcinoma (HCC). However, it often causes severe pain. Therefore, in this study, we performed RFA under deep sedation and investigated its efficacy and safety.
We conducted a retrospective study including 511 HCC patients who received approximately 886 RFA treatments between December 2014 and November 2016 at our institution. Respiratory depression was defined as oxygen saturation of below 90%; and severe body movement was defined as movement caused by pain, which was managed by lowering the power of the generator. Factors associated with respiratory depression and severe body movement were examined via univariate and multivariate regression analyses.
Respiratory depression occurred in 15.3% of the patients and severe body movement in 26.5% of the patients. In the multivariate analysis, BMI (≥ 25 kg/m2, odds ratio [OR] = 1.75, P = 0.035) and longer ablation (≥ 10 min, OR = 2.59, P = 0.002) were significant respiratory depression-related factors. Male sex (OR = 2.02, P = 0.005), Child–Pugh class A (odds ratio = 1.96, P = 0.018), and longer ablation (≥ 10 min, OR = 3.03, P < 0.001) were significant factors related to severe body movement.
Deep sedation for RFA can be performed safely and effectively. Higher BMI and longer ablation were risk factors for respiratory depression and male sex, Child–Pugh class A, and longer ablation were independent predictors of severe body movement during RFA under deep sedation.
KeywordsDeep sedation Hepatocellular carcinoma Percutaneous radiofrequency ablation Respiratory depression Severe body movement
We thank Hideki Hisayasu for providing technical assistance and the participants of the study.
No funding or sponsorship was received for this study or the publication of this article. The article processing charges were funded by the authors. All authors had full access to all of the data in this study and take complete responsibility for the integrity of the data and accuracy of the analysis.
All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.
Koki Sato, Nobuhito Taniki, Ryo Kanazawa, Motonori Shimizu, Shigeto Ishii, Hideko Ohama, Masashi Takawa, Hiroaki Nagamatsu, Yasuharu Imai, and Shuichiro Shiina have nothing to disclose.
Compliance with Ethics Guidelines
All procedures performed in studies involving human participants were in accordance with the ethical standards of Hospital Ethics Committee Juntendo University Hospital and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The requirement for written informed consent was waived.
The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.