&lt;p&gt;Anesthesia for Percutaneous Radiofrequency Tumor Ablation (PRFA): A Review of Current Practice and Techniques&lt;/p&gt;

Piccioni, Federico; Poli, Andrea; Templeton, Leah C.; Templeton, T. Wesley; Rispoli, Marco; Vetrugno, Luigi; Santonastaso, Domenico Pietro; Valenza, Franco

doi:10.2147/lra.s185765

Cited by 32 publications

(23 citation statements)

References 64 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A solution with lidocaine 2% is injected and appears as an anechoic band, which gradually disappears deeply into antero-superior mediastinum, and laterally tools the main vessels of the neck. The risk of major complications decreases with local anesthesia, because the operator can monitor the pain, an early indicator of heat propagation, while a moderate sedation or a general anesthesia prevent the patients’ active collaboration and the early manifestation of complications such as changes in tone of voice, cough or pain ( 10 , 15 , 23 ).…”

Section: Methodsmentioning

confidence: 99%

The Ablation of Thyroid Nodule’s Afferent Arteries Before Radiofrequency Ablation: Preliminary Data

Offi¹,

Garberoglio²,

Antonelli³

et al. 2021

Front. Endocrinol.

View full text Add to dashboard Cite

Induced radiofrequency thermal ablation is the cytoreductive treatment of symptomatic benign thyroid nodules, metastatic and recurrent thyroid tumors and papillary thyroid microcarcinomas. It is a safe and effective alternative to surgery and it allows to obtain satisfactory results in terms of volumetric reduction of the nodule with significant improvement in the quality of life. The trans-isthmic approach and the moving shot technique are the two basic techniques; however, an advanced technique, artery-first feeding radiofrequency ablation, has been developed and validated. We have prospectively included 29 consecutive patients who have undergone radiofrequency ablation (Group A) or artery- first vRFA (Group B). All included patients had a diagnosis of benign nodular goiter and they underwent a single session of radiofrequency ablation. All patients followed a follow-up program at 1 month, 3 months, and 6 months. Continuous variables (age, TSH value, basal volume of nodule, used Joule, time in second of the procedure, nodules’ volume at 1-, 3-, and 6- months of follow-up and percentage of volume reduction at 1-, 3-, and 6- months of follow-up) were described as mean, standard deviation and range, while categorical variables (gender, nodule structure and nodule vascularization) were described as number of cases and percentage. Independent samples t-test were performed to compare the continuous variables. A Test of Proportions was applied to the categorical variables. The Fisher’s exact test was used to analyze the gender. Statistical significance was considered in case of p-value <0.05. Solid structure and spongiform structure showed statistic differences with p-values of 0.022 and 0.023 respectively between two groups. The percentage of reduction at 1 month did not show a significant difference between two groups; instead, the percentage of volume reduction was decreased mostly in the Group B at 3 months and 6 months of follow-up with a p-value of 0.003 and 0.013, respectively. The Joules/energy used showed a statistically significant difference (p-value=0.05), more energy must be used in vascular radiofrequency ablation. These data allow us to hypothesize that vRFA may improve the effectiveness of the procedure, allowing for a reduction in volume more quickly. They were preliminary but promising results, clearly a larger series of cases and prolonged follow-up are needed to clarify and confirm our observations.

show abstract

Section: Methodsmentioning

confidence: 99%

The Ablation of Thyroid Nodule’s Afferent Arteries Before Radiofrequency Ablation: Preliminary Data

Offi¹,

Garberoglio²,

Antonelli³

et al. 2021

Front. Endocrinol.

View full text Add to dashboard Cite

show abstract

“…International Publisher needle in the certain part of the tumour [5,6]. Both general anaesthesia and local anaesthesia are utilized in liver cancer percutaneous radiofrequency [7,8]. Fentanyl (FEN) is a traditional opioid used for pain control and anaesthesia.…”

Section: Ivyspringmentioning

confidence: 99%

“…Percutaneous radiofrequency ablation is a procedure based on tumour necrosis through local tissue heating via applied an electrode needle in the certain part of the tumour 5 , 6 . Both general anaesthesia and local anaesthesia are utilized in liver cancer percutaneous radiofrequency 7 , 8 . Fentanyl (FEN) is a traditional opioid used for pain control and anaesthesia.…”

Section: Introductionmentioning

confidence: 99%

Sedation and Analgesia for Liver Cancer Percutaneous Radiofrequency Ablation: Fentanyl and Oxycodone Comparison

Wang¹,

Yuan²,

Guo³

et al. 2020

Int. J. Med. Sci.

View full text Add to dashboard Cite

Background: Sedation and analgesia use in percutaneous radiofrequency ablation (RFPA) for liver cancer is a necessary part of the procedure; however, the optimal medicine for sedation and analgesia for PRFA remains controversial. The aim of this study was to compare the perioperative pain management, haemodynamic stability and side effects between oxycodone (OXY) and fentanyl (FEN) use in patients under dexmedetomidine sedation. Methods: Two hundred and five adults with an American Society of Anaesthesiologists physical status score of I to II were included in this study. Patients were assigned to the OXY (n=101) or FEN (n=104) group. Radiofrequency ablation was performed under spontaneous breathing and with painless anaesthesia administered intravenously. The outcomes included fluctuations in mean arterial pressure, heart rate, side effects and the perioperative numerical rating scale (NRS). Results: Radiofrequency ablation was successfully performed in 205 patients. No significant differences were observed in mean blood pressure fluctuations between the two groups despite the longer durations of ablation and total sedation time in the OXY group. The highest NRS score during the surgery and 1 hour and 2 hours after the surgery were significantly lower in the OXY group than in the FEN group. Heart rate fluctuations were significantly lower in the OXY group than in FEN group throughout the surgery. More patients in the FEN group displayed unwanted body movement and respiratory depression. Conclusions: Both oxycodone and fentanyl can be applied for liver cancer percutaneous radiofrequency ablation; however, oxycodone provides a better patient experience, lower postoperative pain, less respiratory depression and stable haemodynamic fluctuations.

show abstract

“…Currently there is no consensus on the best anaesthetic approach to patients undergoing CT-guided MWA or RFA. The anaesthetic practice and prescriptions could vary widely, ranging from local anaesthesia alone, to monitored anaesthesia care, to regional anaesthesia, to combined regional and GA 18 . To our knowledge, this is the first study comparing DMB and MMB performance outcomes in CT-guided percutaneous MWA of liver tumour.…”

Section: Discussionmentioning

confidence: 99%

Comparison of deep and moderate neuromuscular blockade in microwave ablation of liver tumours: a randomized-controlled clinical trial

Loh

Yeong

Masohood

et al. 2021

Sci Rep

View full text Add to dashboard Cite

Microwave ablation (MWA) is gaining popularity for the treatment of small primary hepatocellular carcinoma and metastatic lesions especially if patients are not candidates for surgical resection. Deep neuromuscular blockade (DMB) is perceived to improve surgical working conditions compared to moderate neuromuscular blockade (MMB) but no studies have examined the same benefits in MWA of liver tumours. This study aimed to compare the clinical outcomes of DMB and MMB in MWA of liver tumours in terms of liver excursion, performance scores by the interventional radiologists and patients, requirements of additional muscle relaxants and complications. 50 patients were recruited and 45 patients (22 in MMB group, 23 in DMB group) completed the study. The mean liver excursion for the MMB group (1.42 ± 1.83 mm) was significantly higher than the DMB group (0.26 ± 0.38 mm) (p = 0.001). The mean Leiden-Surgical Rating Scale (L-SRS) rated by the two interventional radiologists were 4.5 ± 0.59 and 3.6 ± 0.85 for the DMB and MMB groups, respectively (p = 0.01). There was also statistically significant difference on patient satisfaction scores (0–10: Extremely Dissatisfied–Extremely Satisfied) between DMB (8.74 ± 1.1) and MMB (7.86 ± 1.25) groups (p = 0.01). 5 patients from MMB group and none from DMB group required bolus relaxant during the MWA procedure. Adverse events were also noted to be more severe in the MMB group. In conclusion, DMB significantly reduced liver excursion and movement leading to improved accuracy, safety and success in ablating liver tumour.

show abstract

<p>Anesthesia for Percutaneous Radiofrequency Tumor Ablation (PRFA): A Review of Current Practice and Techniques</p>

Cited by 32 publications

References 64 publications

The Ablation of Thyroid Nodule’s Afferent Arteries Before Radiofrequency Ablation: Preliminary Data

The Ablation of Thyroid Nodule’s Afferent Arteries Before Radiofrequency Ablation: Preliminary Data

Sedation and Analgesia for Liver Cancer Percutaneous Radiofrequency Ablation: Fentanyl and Oxycodone Comparison

Comparison of deep and moderate neuromuscular blockade in microwave ablation of liver tumours: a randomized-controlled clinical trial

Contact Info

Product

Resources

About