Hepatic chemoembolization: effect of intraarterial lidocaine on pain and postprocedure recovery.
OBJECTIVE
To determine if intraarterial lidocaine reduces pain during and after chemoembolization, and whether it influences postprocedure recovery.


METHODS
Two patient cohorts undergoing selective hepatic chemoembolization were compared. Chemoembolization was performed without lidocaine (control group) in 27 patients and intraarterial lidocaine was used (lidocaine group) in 29 similar patients. Objective changes in patient management were assessed. Pain reduction in 31 more procedures with lidocaine (total 60) was assessed and related to tumor type.


RESULTS
During chemoembolization, intraarterial lidocaine reduced the need for additional intravenous analgesics from 69% to 19%. After chemoembolization the mean Dilaudid dose in the first 24 hr was reduced from 9.5 mg to 4.15 mg; accordingly, the mean length of hospital stay was reduced from 67.5 to 53.5 hr. During the day of chemoembolization, the mean oral fluid intake increased from 420 ml (control group) to 487 ml (lidocaine group); the percentage of patients taking solid food on the day of chemoembolization increased from 3% to 43%.


CONCLUSIONS
Intraarterial lidocaine during chemoembolization reduces the severity and duration of pain after chemoembolization resulting in faster recovery thus reducing the length of hospitalization.
Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, 1 Deaconess Road, Boston, MA 02215, USA.
G G
GG
Hartnell
J
J
Gates
K
K
Stuart
J
J
Underhill
D P
DP
Brophy
D000779:Anesthetics, Local / Q000627:therapeutic use*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects*; D006499:Hepatic Artery; D006801:Humans; D007269:Injections, Intra-Arterial; D007902:Length of Stay; D008012:Lidocaine / Q000627:therapeutic use*; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000628:therapy; D009369:Neoplasms / Q000628:therapy; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D010147:Pain Measurement; D011184:Postoperative Period; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome
D000779:Anesthetics, Local; D008012:Lidocaine