Clinical value of lidocaine combined with remifentanil intravenous anesthesia in radiofrequency ablation of liver tumors
10.13929/j.1672-8475.201706033
- VernacularTitle:利多卡因局部麻醉联合瑞芬太尼静脉强化在肝肿瘤射频消融中的临床价值
- Author:
Haochen WANG
1
;
Jian WANG
;
Tianshi LYU
;
Li SONG
;
Xiaoqiang TONG
;
Yinghua ZOU
Author Information
1. 北京大学第一医院介入血管外科
- Keywords:
Radiofrequency ablation;
Anesthesia;
Remifentanil
- From:
Chinese Journal of Interventional Imaging and Therapy
2017;14(11):651-654
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical value of lidocaine combined with remifentanil intravenous anesthesia for radiofrequency ablation of liver tumors.Methods Totally 1 252 patients with hepatic tumors treated by radiofrequency ablation were analyzed.RITA cluster multipole radio needles were used in all cases.Local anesthesia with lidocaine was used before percutaneous puncture,and the dosage was 2 mg/kg of body mass.The initial dose of remifentanil was injected with pump at 0.05 μg/(kg · min) during operation.Mean arterial pressure (MAP),heart rate (HR) and saturation of peripheral oxygen (SPO2) were recorded 24 h before radiofrequency ablation (T0),at the beginning of operation (T1),30 min after operation (T2) and at the end of surgery (T3).Visual analogue scale (VAS) was used to assess the analgesic effect during the whole ablation procedure.Results Radiofrequency ablation were successfully performed in 1 250 patients (1 250/1 252,99.84％).The average time was (59.02 ±14.63) min.The average dosage of remifentanil was (242.22± 22.73)μg.The average VAS score was (2.42± 1.13) points.Compared with the preoperative T0 time point,SPO2 did not change significantly at each time of T1,T2 nor T3,but MAP and HR were significantly higher than those before operation (both P＜0.05).VAS scores were significantly higher in patients with tumors size ＞5 em than those in patients with tumors size ≤5 cm (P＜0.05).VAS scores were significantly higher in patients with lesions under hepatic capsule and in diaphragm dome than in patients with lesions in other parts (both P＜0.05).Severe anesthesia related complications occured in 2 patients,related to the respiratory inhibitory effect of remifentanil,and the patients were completely recovered after corresponding treatment.Conclusion Lidocaine combined with remifentanil intravenous anesthesia for radiofrequency ablation of liver tumors can effectively relieve the pain in patients.Tumor size and tumor location are the main impact factors on analgesic effect.
