title: Artificial Ascites for Pain Relief During Microwave Ablation of Subcapsular Liver Tumors.
abstract: OBJECTIVE
  To compare post-procedure pain of subcapsular hepatic metastasis treated with microwave ablation (MWA) with and without artificial ascites.
  
  
  METHODS
  During a 2-years period, 41 patients underwent MWA of 52 peripheral liver metastases including 20 patients (10 men and 10 women (mean ± SD age: 62 ± 9.3 years) who underwent MWA of 27 metastasis without artificial ascites (group 1), and 21 patients (12 men and 9 women (mean age: 63.5 ± 9.9 years) who underwent MWA of 25 metastasis with artificial ascites (group 2). Patient's pain assessment cores [10-point visual analog scale (VAS)] at 6, 24 h, and 4 days after the MWA procedure were compared among groups, as well as 24 h cumulative morphine dose was also compared among groups. Complications were reported. Statistical significance was evaluated by Fisher's exact test and Student's t test.
  
  
  RESULTS
  Pain VAS were 8.6 ± 2.7, 3.9 ± 1.4, and 0.6 ± 1.2 at 6, 24 h, 4 days, respectively, for group-I and 0.8 ± 1.9, 0.3 ± 0.9, and 6.6 ± 3.5 for group II. Pain VAS were significantly different at 6, 24 h, and 4 days between the two groups (p < 0.0001). The average 24 h dose of morphine was 5.8 ± 2.2 mg in group-I and 0.2 ± 0.6 mg in group-II (p < 0.0001). Complications occurred in two patients from group-I (10%), including one bilio-pleural fistula and one minor cutaneous burn. One patient (9.5%) in group-II developed a lobar infarction. No bleeding and no procedure-related death were reported.
  
  
  CONCLUSIONS
  Artificial ascites prevents immediate post-procedural pain, which re-appears intensively 4 days later.
authors.affiliation: Gustave Roussy Institute, 39 r Camille Desmoulins, Villejuif, 94805, France. thakime@yahoo.com.|Department of Interventional Radiology, Institute Gustave Roussy, 114 Rue Edouard-Vaillant, Villejuif, 94805, France. thakime@yahoo.com.
authors.forename: Antoine
authors.initials: A
authors.lastname: Hakimé
authors.affiliation: Gustave Roussy Institute, 39 r Camille Desmoulins, Villejuif, 94805, France. Lambros.tselikas@gustaveroussy.fr.
authors.forename: Lambros
authors.initials: L
authors.lastname: Tselikas
authors.affiliation: Saint Jean de Dieu, 17 rue Oudinot, Paris, 75007, France. yotmezguine@ccpsc.com.
authors.forename: Yves
authors.initials: Y
authors.lastname: Otmezguine
authors.affiliation: Gustave Roussy Institute, 39 r Camille Desmoulins, Villejuif, 94805, France. frederic.deschamps@igr.fr.
authors.forename: Frederic
authors.initials: F
authors.lastname: Deschamps
authors.affiliation: Gustave Roussy Institute, 39 r Camille Desmoulins, Villejuif, 94805, France. Debaere@igr.fr.
authors.forename: Thierry
authors.initials: T
authors.lastname: de Baere
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001201:Ascites; D017115:Catheter Ablation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000628:therapy*; D008297:Male; D008872:Microwaves; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D016896:Treatment Outcome
keywords: Artificial ascites; Microwave ablation; Pain