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Intraarterial Lidocaine Administration for Pain Control by Water-in-Oil Technique in Transarterial Chemoembolization: in vivo and Randomized Clinical Trial
- Source :
- Journal of Hepatocellular Carcinoma
- Publication Year :
- 2021
-
Abstract
- Li-Zhou Wang,1,* Xiao-Xia Hu,2,* Xiang-Chun Shen,2,3 Tian-Cheng Wang,4 Shi Zhou1 1Department of Interventional Radiology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, Peopleâs Republic of China; 2The State Laboratory of Functions and Application of Medicinal Plants, Guizhou Medical University, Guiyang, Guizhou, Peopleâs Republic of China; 3School of Pharmaceutical Sciences, Guizhou Medical University, Guiyang, Guizhou, Peopleâs Republic of China; 4Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, Peopleâs Republic of China*These authors contributed equally to this workCorrespondence: Tian-Cheng WangDepartment of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, Peopleâs Republic of ChinaTel +86 15073190153Email 421176806@qq.comShi ZhouDepartment of Interventional Radiology, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, 550004, Peopleâs Republic of ChinaTel +86 13809477708Email zhoushi@gmc.edu.cnObjective: To investigate the sustained release of lidocaine from a lidocaineâepirubicinâlipiodol emulsion created by water-in-oil (W/O) technique in vivo and evaluate the efficacy and safety of intraarterial lidocaine administration for intra- and postoperative pain control in transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).Methods: The in vivo concentrations of lidocaine were determined in tumor tissues after VX2 rabbit models for hepatic tumor were administered with intra-arterial lidocaineâepirubicinâlipiodol emulsion. A prospective randomized controlled clinical trial was performed, enrolling 70 consecutive patients who underwent TACE. Patients were randomized into two groups: Group A received an immediate bolus intraarterial lidocaine injection before TACE, and Group B received a lidocaineâepirubicinâlipiodol emulsion during TACE. Pain intensity was compared between the two groups using a visual analog scale (VAS) score before (Tbefore) and at 0 h (T0), 4 h (T4), 8 h (T8), 24 h (T24), 48 h (T48), and 72 h (T72) after the procedure. Adverse events and intake of analgesics were evaluated and compared between the two groups.Results: The concentrations of lidocaine in tumor tissues were higher in experimental group than in control group at T0.5 (P=0.004), T1 (P=0.038), T4 (P=0.036), and T8 (P=0.029). In the clinical trial, VAS scores in Group B were significantly lower than in Group A at T0 (P=0.006), T4 (P=0.001), T8 (P=0.002), and T24 (P=0.005). The tramadol intake in Group B was significantly lower than in Group A (P=0.021). No significant difference was observed regarding the incidence of adverse events between the two groups.Conclusion: This study demonstrated the effectiveness and safety of intraarterial lidocaine administration using the W/O technique in controlling intra- and post-TACE pain.Keywords: carcinoma, hepatocellular, chemoembolization, therapeutic, lidocaine hydrochloride, pain management
- Subjects :
- Lidocaine
business.industry
Visual analogue scale
lidocaine hydrochloride
Lidocaine Hydrochloride
carcinoma
law.invention
Clinical trial
therapeutic
Bolus (medicine)
hepatocellular
Randomized controlled trial
pain management
law
Anesthesia
Medicine
Tramadol
Adverse effect
business
chemoembolization
Journal of Hepatocellular Carcinoma
medicine.drug
Original Research
Subjects
Details
- ISSN :
- 22535969
- Volume :
- 8
- Database :
- OpenAIRE
- Journal :
- Journal of hepatocellular carcinoma
- Accession number :
- edsair.doi.dedup.....0c113b237f7edfdd251a4c10991ad65b