Efficacy and Safety of Deep Sedation in Percutaneous Radiofrequency Ablation for Hepatocellular Carcinoma

• DOI: 10.1007/s12325-018-0865-z
• Publication Date: 2019-01-03T11:07:27Z
• Authors: Koki Sato; Nobuhito Taniki; Ryo Kanazawa; Motonori Shimizu; Shigeto Ishii; Hideko Ohama; Masashi Takawa; Hiroaki Nagamatsu; Yasuharu Imai; Shuichiro Shiina
• Keywords: Adult; Male; Carcinoma, Hepatocellular; Liver Neoplasms; Middle Aged; Pain, Procedural; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Catheter Ablation; Humans; Female; Deep Sedation; Aged; Neoplasm Staging; Retrospective Studies

Radiofrequency ablation (RFA) has been accepted as safe and effective for treating early-stage hepatocellular carcinoma (HCC). However, it often causes severe pain. Therefore, in this study, we performed RFA under deep sedation and investigated its efficacy and safety.We conducted a retrospective study including 511 HCC patients who received approximately 886 RFA treatments between December 2014 and November 2016 at our institution. Respiratory depression was defined as oxygen saturation of below 90%; and severe body movement was defined as movement caused by pain, which was managed by lowering the power of the generator. Factors associated with respiratory depression and severe body movement were examined via univariate and multivariate regression analyses.Respiratory depression occurred in 15.3% of the patients and severe body movement in 26.5% of the patients. In the multivariate analysis, BMI (≥ 25 kg/m2, odds ratio [OR] = 1.75, P = 0.035) and longer ablation (≥ 10 min, OR = 2.59, P = 0.002) were significant respiratory depression-related factors. Male sex (OR = 2.02, P = 0.005), Child-Pugh class A (odds ratio = 1.96, P = 0.018), and longer ablation (≥ 10 min, OR = 3.03, P < 0.001) were significant factors related to severe body movement.Deep sedation for RFA can be performed safely and effectively. Higher BMI and longer ablation were risk factors for respiratory depression and male sex, Child-Pugh class A, and longer ablation were independent predictors of severe body movement during RFA under deep sedation.