Psychological intervention reduces postembolization pain during hepatic arterial chemoembolization therapy: a complementary approach to drug analgesia.
OBJECTIVE
To assess whether psychological intervention reduces postembolization pain during hepatic arterial chemoembolization therapy.


METHODS
Two hundred and sixty-two patients, who required hepatic arterial chemoembolization for hepatic malignancy and postembolization pain, were randomized into control group (n = 46, receiving medication) and intervention group (n = 216, receiving psychological intervention and medication in turn). The symptom checklist-90 (SCL-90) was used to scale the psychological symptoms of the patients before operation. Pain was scored with a 0 to 10 numeric rating scale (NRS-10) before and after analgesia as well as after psychological intervention (only in intervention group).


RESULTS
All psychological symptomatic scores measured with SCL-90 in the intervention group were higher than the normal range in Chinese (P < 0.05). The somatization, phobia and anxiety symptomatic scores were associated with pain numerical rating score before analgesia (r = 0.141, 0.157 and 0.192, respectively, P < 0.05). Patients in both groups experienced pain relief after medication, psychotherapy or psychotherapy combined with medication during the procedure (P < 0.01). Only some patients in the intervention group reported partial or entire pain relief (29.17% and 2.31%) after psychological intervention. The pain score after analgesia in the intervention group was significantly lower than that in the control group (P < 0.01).


CONCLUSIONS
Severe psychological distress occurs in patients with hepatic malignancy. Psychological intervention reduces pain scores significantly during hepatic arterial chemoembolization therapy and is thus, highly recommended as a complementary approach to drug analgesia.
Wang
Zi-Xuan
ZX
Department of Interventional Radiology, Qingdao Municipal Hospital, Qingdao 266000, Shandong Province, China. prince_room@sina.com
Liu
Si-Liang
SL
Sun
Chun-Hui
CH
Wang
Qian
Q
D000293:Adolescent; D000328:Adult; D000368:Aged; D000698:Analgesia / Q000523:psychology*; D000700:Analgesics / Q000627:therapeutic use*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects*; D000529:Complementary Therapies; D005260:Female; D006499:Hepatic Artery / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008113:Liver Neoplasms / Q000523:psychology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000523:psychology
D000700:Analgesics