Radiofrequency ablation of peripheral liver tumors: Intraperitoneal 5% dextrose in water decreases postprocedural pain
Radiofrequency ablation of peripheral liver tumors: Intraperitoneal 5% dextrose in water decreases postprocedural pain
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DOI：
10.2214/ajr.05.0140
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发表时间：
2006-05-01
影响因子：
5
通讯作者：
Lee, FT
中科院分区：
文献类型：
--
作者：
Hinshaw, JL;Laeseke, PF;Lee, FT
目标。目的：评价射频消融术中应用5%葡萄糖水溶液(D5W)治疗周围型肝肿瘤的临床疗效。这项病例对照研究比较了在我们机构接受射频消融治疗周围肝肿瘤的最后20名患者的住院时间。D5W组连续10例(女性7例，男性3例；年龄37~78岁，平均58岁)在消融前经腹膜腔内注射D5W(平均963 436[SD]mL)。将这组患者与未接受腹膜内D5W治疗的10名患者(5名男性和5名女性，年龄范围36-73岁，平均54岁)进行比较。结果：尽管患者自控止痛剂的用量显著减少(17.3vs125.1 mg吗啡，p=0.003)，但D5W组患者术后24小时内报告的疼痛显著低于对照组(2.3vs6.3，p=0.003)。两组在疼痛和患者自控止痛使用方面的差异在前16小时最大，并随着时间的推移而下降。D5W组消融总量(61.9vs45.2 cm(3)，p=0.44)、肝表面受累(6.2vs6.0 cm，p=0.73)和消融次数(1.8vs1.1，p=0.14)均略高于对照组，但差异无统计学意义。D5W预处理的效果在术后前16小时效果最好。
OBJECTIVE. Our objective was to evaluate the clinical efficacy of the intraperitoneal instillation of 5% dextrose in water (D5W) during radiofrequency ablation of peripheral liver tumors for decreasing postradiofrequency pain and narcotic use.MATERIALS AND METHODS. This case-control study compared the hospital course of the last 20 patients to undergo radiofrequency ablation of peripheral liver tumors at our institution. Ten consecutive subjects in the D5W group (seven women and three men; age range, 37-78 years; mean 58 years) were pretreated with intraperitoneal D5W (average, 963 436 [SD] mL) before the ablation. This group was compared with a control group of 10 patients (five men and five women; age range, 36-73 years; mean, 54 years) who did not receive intraperitoneal D5W. The size of the ablation zone, degree of liver capsule involvement, number of bums, patient-reported pain, patient-controlled analgesia use, and length of hospital stay were recorded and compared between the groups.RESULTS. The patients in the D5W group reported significantly less pain in the first 24 hr after the procedure than did the controls (2.3 vs 6.3, p = 0.003) despite a significant decrease in patient-controlled analgesia use (17.3 vs 125.1 mg of morphine, p = 0.003). The differences in pain and patient-controlled analgesia use were greatest in the first 16 hr and decreased over time in both groups. The total volume of ablation (61.9 vs 45.2 cm(3), p = 0.44), liver surface involvement (6.2 vs 6.0 cm, p = 0.73), and number of bums (1.8 vs 1.1, p = 0.14) were slightly higher in the D5W group than in the control group, but this difference was not statistically significant.CONCLUSION. Pretreatment with intraperitoneal D5W before radiofrequency ablation of peripheral liver tumors decreased pain, narcotic use, and length of hospital stay. The effect of pretreatment with D5W is greatest in the first 16 hr after the procedure.