Mediation of transcatheter arterial chemoembolization induced gastric slow-wave dysrhythmia by endogenous prostaglandin.
OBJECTIVE
In recent years, gastric slow-wave dysrhythmias induced by transcatheter arterial chemoembolization (TACE) have been observed. Enhanced endogenous prostaglandin may be a possible mechanism for the myoelectrical changes. The aim of this study was to evaluate whether the gastric slow-wave dysrhythmias induced by TACE may be mediated by ketoprofen, a prostaglandin synthesis inhibitor.


METHODS
Twenty-three patients with hepatocellular carcinoma (HCC) admitted for TACE were enrolled. A follow-up TACE was scheduled to take place 2 months later. During the next admission for TACE, 50 mg of ketoprofen was given intramuscularly 12 h for 3 days, beginning 48 h before TACE, as premedication. Cutaneous electrogastrography (EGG) was performed before and within 24 h after TACE.


RESULTS
The results showed that the change in the fasting EGG parameters after TACE without premedication was not statistically significant. However, the postprandial EGG parameters, including the dominant frequency (DF); the percentages of DF in the normal, bradygastric and tachygastric range; along with the dominant frequency instability coefficient, deteriorated significantly after the procedure (P < 0.01). After the follow-up TACE with ketoprofen premedication, neither the fasting nor postprandial EGG parameters in the control group changed significantly.


CONCLUSIONS
Gastric slow-wave dysrhythmias induced by TACE may be mediated by ketoprofen, a prostaglandin synthesis inhibitor, in HCC patients. However, the improvement in the gastric myoelectrical activity does not eliminate the degree of nausea/vomiting after TACE.
Chang
Chi-Sen
CS
Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, Taiwan. changcs.vghtc.vghtc.gov.tw
Yang
Sheng-Sun
SS
Yeh
Hong-Zen
HZ
Ko
Chung-Wang
CW
Lien
Han-Chung
HC
Chen
Gran-Hum
GH
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects*; D004568:Electrodiagnosis / Q000379:methods; D005260:Female; D006801:Humans; D007660:Ketoprofen / Q000627:therapeutic use*; D008113:Liver Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016065:Myoelectric Complex, Migrating / Q000502:physiology*; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D011292:Premedication; D011448:Prostaglandin Antagonists / Q000627:therapeutic use*; D011453:Prostaglandins / Q000502:physiology; D013270:Stomach / Q000503:physiopathology*
D011448:Prostaglandin Antagonists; D011453:Prostaglandins; D007660:Ketoprofen