[Neuroleptanalgesia in patients undergoing percutaneous, ultrasound-directed radiofrequency for primary or secondary, single or multiple hepatic neoplasms].
BACKGROUND
The use of percutaneous ultrasound-directed radiofrequency is a recent technique in non-surgical therapy of some neoplastic liver lesions. Purpose of this study is to demonstrate that the use of a narcosis-free analgesia allows to perform this procedure, which is generally painful and badly by the patient.


METHODS
We treated 51 patients for a total of 126 procedures; the first 17 patients underwent a mono- or multipolar technique with uncooled electrodes, while the remaining 34 patients have been treated with double perfusion lumen electrodes with the chance of tipcooling. We used diidrobenzoperydol and fentanyl with a mean dose for each session of 209 micrograms for the first 17 patients and 109 micrograms for the other 34.


RESULTS
Using VAS, we obtained a painless procedure in 42 patients and mild-pain sensations in 9 patients, while one hour after the procedure painless or light-pain sensation were observed in 49 patients and mild-pain in 2 patients, which required the use of FANS i.v. At discharge, all patients were pain-free or with very light pain sensation. We reduced the intra-hospital observation of patients from 5 to 3 hours, once the technique has been modified. 4 patients complained about nausea and 1 of these emesis. We did not observe any cardiovascular, respiratory and/or neurological complications.


CONCLUSIONS
The use of neuroleptanalgesia allowed us to perform the described procedure with a good feeling by the patients.
U O Anestesia e Rianimazione, ASL N. 3, Busto Arsizio, Varese.
G
G
Crespi
D
D
Ruffa
S
S
Farioli
M D
MD
Centemeri
G
G
Servadio
E
E
Foglia
E
E
Chiarello
L
L
Solbiati
T
T
Ierace
M
M
Dellanoce
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000532:radiotherapy* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009458:Neuroleptanalgesia; D014465:Ultrasonics
Neuroleptoanalgesia in pazienti sottoposti a radiofrequenza percutanea ecoguidata per neoplasie epatiche primitive o secondarie, singole o multiple.