title: Right thoracic paravertebral anaesthesia for percutaneous radiofrequency ablation of liver tumours.
abstract: OBJECTIVE
  Percutaneous radiofrequency ablation (PRFA) of liver tumours performed under local anaesthesia and intravenous sedation can cause severe pain to patients. This prospective study evaluated the efficacy of a right thoracic paravertebral block (TPVB) for anaesthesia and analgesia during PRFA of liver tumours.
  
  
  METHODS
  20 patients, aged 44-74 years, with liver malignancies received a multiple injection TPVB at the T6-10 levels 30 min before the PRFA. An intravenous infusion of propofol (3-5 mg kg(-1) h(-1)) was administered to patients who requested to be sedated and intravenous fentanyl (25 µg bolus) was administered as rescue analgesia. Pain during the TPVB and PRFA was assessed using a numerical rating scale (NRS; 0, no pain; 10, worst imaginable pain). Patients were also assessed for residual pain and analgesic consumption during the 24 h after the intervention.
  
  
  RESULTS
  The TPVB was well tolerated and produced ipsilateral sensory anaesthesia with satisfactory spread (median (range); 8 (6-11) dermatomes). The PRFA procedure caused mild pain (mean (standard deviation, SD); NRS 1.4 (1.9)) during the insertion of the ablation needle and the peak pain intensity during the therapeutic burn was moderate (mean (SD); NRS 5.0 (3.3)) in severity. During the 24 h after the PRFA, patients reported minimal pain and consumed very few analgesics. The mean (SD) satisfaction score (0, totally dissatisfied; 10, very satisfied) of the patients was 8.9 (1.1) and that of the radiologists was 8.8 (1.4).
  
  
  CONCLUSIONS
  A right TPVB is safe and effective for anaesthesia and analgesia during PRFA of malignant liver tumours.
authors.affiliation: Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, People's Republic of China. cheungning2@gmail.com
authors.forename: M
authors.initials: M
authors.lastname: Cheung Ning
authors.forename: M K
authors.initials: MK
authors.lastname: Karmakar
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000008:administration & dosage*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D005471:Fluoroscopy; D006801:Humans; D007262:Infusions, Intravenous; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000517:prevention & control; D015742:Propofol / Q000008:administration & dosage*; D011446:Prospective Studies; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging
chemical_list: D000700:Analgesics; D005283:Fentanyl; D015742:Propofol