Comparative Effects of Dexmedetomidine and Propofol on US-Guided Radiofrequency Ablation of Hepatic Neoplasm Under Monitored Anesthesia Care: A Randomized Controlled Study.
Percutaneous radiofrequency ablation (RFA) is a useful and safe procedure for treating hepatic neoplasm. However, liver RFA causes severe pain, which thereby increases the demand for monitored anesthesia care (MAC). Here, we compared the efficacy and safety of propofol and dexmedetomidine, which are commonly administered during MAC when performing RFA to assess hepatic neoplasm.In this randomized controlled trial, 40 patients were randomly allocated to 2 groups for elective RFA. Patients received either dexmedetomidine (group D) or propofol (group P). Both groups received the continuous infusion of remifentanil for pain control. The primary outcomes were opioid consumption and differences in partial pressure of arterial carbon dioxide (PaCO2) between pre- and postprocedure RFA. In addition, hemodynamic parameters, patient satisfaction, and interventional radiologist satisfaction were determined.There were significant differences in opioid consumption (50.1 ± 16.8 ng/kg/min [group D] vs 71.2 ± 18.7 ng/kg/min [group P]; P = 0.001) and delta PaCO2 (10.4 ± 6.4 mm Hg vs 17.2 ± 9.2 mm Hg, respectively; P = 0.016). Moreover, respiratory rates were significantly different between groups during RFA (P < 0.001). However, blood pressure and heart rate did not significantly change during RFA. Neither patient nor interventional radiologist satisfaction was significantly different between groups.Dexmedetomidine provides better respiratory stability and reduces opioid consumption in comparison with propofol when administered under MAC when performing RFA for hepatic neoplasm.
From the Department of Anesthesiology and Pain Medicine (K-WJ, S-SC, D-MJ, Y-GK, J-HS, M-HS), Asan Medical Center, University of Ulsan College of Medicine, Seoul; Department of Anesthesiology and Pain Medicine (H-ML), Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung; and Department of Radiology (H-JW, Y-MS, P-NK), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Kyoung-Woon
KW
Joung
Seong-Soo
SS
Choi
Dong-Min
DM
Jang
Yu-Gyeong
YG
Kong
Hwa-Mi
HM
Lee
Ji-Hoon
JH
Shim
Hyung-Jin
HJ
Won
Yong-Moon
YM
Shin
Pyo-Nyun
PN
Kim
Myung-Hee
MH
Song
D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use*; D017115:Catheter Ablation / Q000379:methods*; D020927:Dexmedetomidine / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D010880:Piperidines / Q000008:administration & dosage / Q000627:therapeutic use*; D015742:Propofol / Q000008:administration & dosage / Q000627:therapeutic use*; D000077208:Remifentanil
D000700:Analgesics; D010880:Piperidines; D020927:Dexmedetomidine; D000077208:Remifentanil; D015742:Propofol