WITHDRAWN: Thoracic blockade in percutaneous hepatocellular carcinoma.

Abstract

Background Hepatocellular carcinoma (HCC) is a primary liver tumor that generally develops in a marsh-altered liver. Local ablation using radio frequency waves is the first-line treatment for patients with early onset of this cancer who cannot undergo radical surgery. This is a painful procedure and must be performed under deep intravenous analgosedation or general anesthesia. The method that appears to meet the anesthesiological and surgical requirements is thoracic paravertebral block.Aim of the study The main purpose of the study was to determine the efficacy and safety of paravertebral block compared to local perioperative anesthesia in patients who had percutaneous thermoablation as a treatment for HHC.Methods 30 patients enrolled in the treatment of hepatocellular carcinoma by percutaneous thermoablation were enrolled in the study. Two groups of patients were compared: group PVBpatients under paravertebral block anesthesia, group BB -patients under local anesthesia, without paravertebral block. ResultsThe use of paravertebral blockade (PVB) did not significantly reduce the patient's concerns about the postoperative period, the ability to ask questions to the doctor, receive understandable information about anesthesia, reduce stress levels or increase the level of satisfaction with pain therapy in the postoperative period (p> 0.05). Patients significantly more often experienced pain during surgery without paravertebral block (p <0.001). Side effects of anesthesia occurred in both compared groups. They mainly concerned nausea and vomiting, which significantly more often occurred in the group without blockade (BB) and affected up to 60% of the respondents (p = 0.008).Significantly more often any painkillers were used among BB patients compared to PVB, respectively: immediately after surgery 53% vs 13% (p = 0.02), 1 hour after surgery 80% vs 27% (p = 0.003), 3h after surgery 80% vs 14% (p <0.001), 6h after surgery 60% vs 14% (p = 0.008), after 24h 47% vs 20% (p = 0.12). ConclusionsThe paravertebral block has proved to be a safe and well-tolerated and effective method of treating postoperative pain in patients with liver cancer treated by percutaneous thermoablation.Patients with PVB during the surgery and in the postoperative period had significantly less pain than HCC -Hepatocellular Carcinoma -hepatocellular carcinoma PEI -Percutaneous Ethanol Injection -percutaneous ethanol injection RA -Regional Anaesthesia -regional anesthesia RFA -Radiofrrequency Ablation -ablation using radio frequency waves PRFA -Percutaneus Radiofrrequency Ablation -transcutaneous ablation using radio frequency waves SBP -Systolic Blood Pressure SpO2 -Oxygen Saturation -oxygen saturation of arterial blood TPVB -Thoracic ParaVertebral Block -chest block Declarations Ethics Approval and Consent to Participate -all patients gave written consent for participation, in addition, Consent of the Bioethics Committee: Resolution No. 46/2017 of 9/11/2017 issued by the LG -collecting clinical materials; clinical material analysis; substantive supe...