Radiofrequency ablation of peripheral liver tumors: intraperitoneal 5% dextrose in water decreases postprocedural pain.
OBJECTIVE
Our objective was to evaluate the clinical efficacy of the intraperitoneal instillation of 5% dextrose in water (D5W) during radiofrequency ablation of peripheral liver tumors for decreasing postradiofrequency pain and narcotic use.


METHODS
This case-control study compared the hospital course of the last 20 patients to undergo radiofrequency ablation of peripheral liver tumors at our institution. Ten consecutive subjects in the D5W group (seven women and three men; age range, 37-78 years; mean, 58 years) were pretreated with intraperitoneal D5W (average, 963 +/- 436 [SD] mL) before the ablation. This group was compared with a control group of 10 patients (five men and five women; age range, 36-73 years; mean, 54 years) who did not receive intraperitoneal D5W. The size of the ablation zone, degree of liver capsule involvement, number of burns, patient-reported pain, patient-controlled analgesia use, and length of hospital stay were recorded and compared between the groups.


RESULTS
The patients in the D5W group reported significantly less pain in the first 24 hr after the procedure than did the controls (2.3 vs 6.3, p = 0.003) despite a significant decrease in patient-controlled analgesia use (17.3 vs 125.1 mg of morphine, p = 0.003). The differences in pain and patient-controlled analgesia use were greatest in the first 16 hr and decreased over time in both groups. The total volume of ablation (61.9 vs 45.2 cm(3), p = 0.44), liver surface involvement (6.2 vs 6.0 cm, p = 0.73), and number of burns (1.8 vs 1.1, p = 0.14) were slightly higher in the D5W group than in the control group, but this difference was not statistically significant.


CONCLUSIONS
Pretreatment with intraperitoneal D5W before radiofrequency ablation of peripheral liver tumors decreased pain, narcotic use, and length of hospital stay. The effect of pretreatment with D5W is greatest in the first 16 hr after the procedure.
Hinshaw
J Louis
JL
Department of Radiology, University of Wisconsin, Madison, WI 53792, USA.
Laeseke
Paul F
PF
Winter
Thomas C
TC
Kliewer
Mark A
MA
Fine
Jason P
JP
Lee
Fred T
FT
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D017115:Catheter Ablation / Q000009:adverse effects*; D005260:Female; D005947:Glucose / Q000008:administration & dosage*; D006801:Humans; D007322:Instillation, Drug; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D010537:Peritoneum; D012189:Retrospective Studies; D014867:Water / Q000008:administration & dosage
D014867:Water; D005947:Glucose