Abstract
Radiofrequency ablation (RFA) is frequently used to treat early stage hepatocellular carcinoma. Two of the most cumbersome side-effects of the ablation procedure are intractable pain and vagotonia when deep sedation is not used. We describe local injection of anesthetic into Glisson's sheath as a new technique for overcoming these problems. Lidocaine was injected into Glisson's sheath when radiofrequency ablation of hepatocellular carcinomas, which were located adjacent to Glisson's sheath, could not be continued due to severe pain (n=8) or bradycardia (n=3). In all three patients who showed vagotonia with bradycardia during the ablations, injection of lidocaine prevented bradycardia, allowing completion of the radiofrequency ablation. Pain was reduced in all eight patients who experienced pain during ablation. No side-effects were observed during the procedures. Injection of anesthetic into Glisson's sheath is simple and effective for reducing intractable pain and vagotonia associated with RFA.
| Original language | English |
|---|---|
| Pages (from-to) | 1367-1370 |
| Number of pages | 4 |
| Journal | Hepatology Research |
| Volume | 44 |
| Issue number | 13 |
| DOIs | |
| Publication status | Published - 2014 |
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Keywords
- Complications
- Hepatocellular carcinoma
- Pain
- Radiofrequency ablation
ASJC Scopus subject areas
- Hepatology
- Infectious Diseases
Cite this
Prevention of vagotonia and pain during radiofrequency ablation of liver tumors. / Nakamura, Shinichiro; Nouso, Kazuhiro; Ohnishi, Hideki; Kuwaki, Kenji; Hagihara, Hiroaki; Takeuchi, Yasuto; Wada, Nozomu; Morimoto, Yuki; Miyahara, Koji; Yasunaka, Tetsuya; Ikeda, Fusao; Miyake, Yasuhiro; Kobayashi, Yoshiyuki; Shiraha, Hidenori; Ishikawa, Shinichi; Takaki, Akinobu; Yamamoto, Kazuhide.
In: Hepatology Research, Vol. 44, No. 13, 2014, p. 1367-1370.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Prevention of vagotonia and pain during radiofrequency ablation of liver tumors
AU - Nakamura, Shinichiro
AU - Nouso, Kazuhiro
AU - Ohnishi, Hideki
AU - Kuwaki, Kenji
AU - Hagihara, Hiroaki
AU - Takeuchi, Yasuto
AU - Wada, Nozomu
AU - Morimoto, Yuki
AU - Miyahara, Koji
AU - Yasunaka, Tetsuya
AU - Ikeda, Fusao
AU - Miyake, Yasuhiro
AU - Kobayashi, Yoshiyuki
AU - Shiraha, Hidenori
AU - Ishikawa, Shinichi
AU - Takaki, Akinobu
AU - Yamamoto, Kazuhide
PY - 2014
Y1 - 2014
N2 - Radiofrequency ablation (RFA) is frequently used to treat early stage hepatocellular carcinoma. Two of the most cumbersome side-effects of the ablation procedure are intractable pain and vagotonia when deep sedation is not used. We describe local injection of anesthetic into Glisson's sheath as a new technique for overcoming these problems. Lidocaine was injected into Glisson's sheath when radiofrequency ablation of hepatocellular carcinomas, which were located adjacent to Glisson's sheath, could not be continued due to severe pain (n=8) or bradycardia (n=3). In all three patients who showed vagotonia with bradycardia during the ablations, injection of lidocaine prevented bradycardia, allowing completion of the radiofrequency ablation. Pain was reduced in all eight patients who experienced pain during ablation. No side-effects were observed during the procedures. Injection of anesthetic into Glisson's sheath is simple and effective for reducing intractable pain and vagotonia associated with RFA.
AB - Radiofrequency ablation (RFA) is frequently used to treat early stage hepatocellular carcinoma. Two of the most cumbersome side-effects of the ablation procedure are intractable pain and vagotonia when deep sedation is not used. We describe local injection of anesthetic into Glisson's sheath as a new technique for overcoming these problems. Lidocaine was injected into Glisson's sheath when radiofrequency ablation of hepatocellular carcinomas, which were located adjacent to Glisson's sheath, could not be continued due to severe pain (n=8) or bradycardia (n=3). In all three patients who showed vagotonia with bradycardia during the ablations, injection of lidocaine prevented bradycardia, allowing completion of the radiofrequency ablation. Pain was reduced in all eight patients who experienced pain during ablation. No side-effects were observed during the procedures. Injection of anesthetic into Glisson's sheath is simple and effective for reducing intractable pain and vagotonia associated with RFA.
KW - Complications
KW - Hepatocellular carcinoma
KW - Pain
KW - Radiofrequency ablation
UR - http://www.scopus.com/inward/record.url?scp=84927575417&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84927575417&partnerID=8YFLogxK
U2 - 10.1111/hepr.12321
DO - 10.1111/hepr.12321
M3 - Article
AN - SCOPUS:84927575417
VL - 44
SP - 1367
EP - 1370
JO - Hepatology Research
JF - Hepatology Research
SN - 1386-6346
IS - 13
ER -