The Effectiveness of Ultrasound-Guided Thoracic Paravertebral Block for Percutaneous Radiofrequency Ablation of Hepatic Tumors: A Pilot Study

• Published in: Journal of the Korean Society of Radiology Vol. 79; no. 6; pp. 323 - 331
• Main Authors: Kim, Hyungtae, Kim, Youngjun, Kim, Beum Jin, Shin, Sung In, Yim, So Mang, Lee, Ju-Hyung
• Format: Journal Article
• Language: English
• Published: The Korean Society of Radiology 01.12.2018; 대한영상의학회
• Subjects: liver neoplasms; nerve block; radiofrequency catheter ablation; 방사선과학
• ISSN: 1738-2637; 2288-2928; 2951-0805
• DOI: 10.3348/jksr.2018.79.6.323

Purpose The purpose of this study was to evaluate the effectiveness of thoracic paravertebral block (TPVB) for management of pain during and after percutaneous radiofrequency ablation (RFA) of hepatic tumor. Materials and Methods All patients were divided into non-TPVB (4 patients, 4 sessions of RFA for 4 tumors) and TPVB group (5 patients, 7 sessions of RFAs for 7 tumors). Ultrasound (US)-guided TPVB was performed at T7 level. The 15 mL of 0.375% ropivacaine was injected into right paravertebral space before RFA. If patients complained pain and asked analgesics or experienced pain with verbal numerical rating scale (VNRS) of more than 4, fentanyl 25 µg (up to 100 µg), pethidine 25 mg, and midazolam 0.05 mg/kg (up to 5 mg) were sequentially given intravenously during RFA. Results Total intravenous morphine equivalence of analgesics before, during, and after RFA was 129.1 mg and 0.0 mg in non-TPVB and TPVB group, respectively. Conclusion US-guided TPVB may be an effective and safe anesthetic method for decreasing or eliminating pain during and after RFA for hepatic tumor and helpful in decreasing the usage of opioids.