The Effects of Thoracic Epidural Analgesia during Percutaneous Radiofrequency Ablation for Hepatocellular Carcinoma

BACKGROUND: Percutaneous radiofrequency ablation (PRFA) is a useful and safe treatment for hepatocellular carcinoma (HCC). Pain management, during and after PRFA, is a critical component of patient care. OBJECTIVES: This study reviewed the efficacy of thoracic epidural analgesia, during and after PRFA, for patients with HCC. STUDY DESIGN: A retrospective, observational chart review. SETTING: Tertiary medical center/teaching hospital. METHODS: Patients who had undergone PRFA for HCC in the past 5 years were divided into two groups, based on the type of anesthesia administered: thoracic epidural anesthesia group (Group E) and local anesthesia with monitored anesthesia care group (Group C). We retrospectively reviewed changes in the numeric rating scale (NRS) score during and after PRFA, opioid consumption, length of the procedure, length of hospital stay, changes in blood pressure during PRFA, and the incidence of adverse events. RESULTS: The NRS score in Group E was significantly lower than that in Group C (P < 0.05). The opioid consumption in Group E was lower than that in Group C after PRFA (P < 0.05). The procedure time was shorter in Group E (P < 0.05). Neither of the groups showed significant difference with respect to the length of hospital stay and the incidence of respiratory depression, fever, and blood pressure elevation. The incidence of nausea, vomiting, and voiding difficulty was higher in Group E. LIMITATIONS: This study is limited by its retrospective design. CONCLUSIONS: Thoracic epidural analgesia was associated with shorter procedure times, lower postprocedural pain, and lower opioid consumption during and after PRFA for HCC.