Reduced Periprocedural Analgesia After Replacement of Water for Injection with Glucose 5% Solution as the Infusion Medium for 90Y-Resin Microspheres.
The primary aim of our study was to compare the need for periinterventional on-demand analgesia when water for injection (WFI) was replaced with glucose 5% (G5) for90Y-resin microsphere administration.


METHODS
Forty-one patients who received 77 radioembolization procedures with G5 (2014-2015) were retrospectively matched with 41 patients (77 radioembolization procedures) who received radioembolization with WFI (2011-2014) at our center. The need for on-demand pain medication was chosen as an objective and accessible measure of periprocedural pain experienced by patients.


RESULTS
Patients were well matched according to sex, age, tumor type and involvement, and prior antiangiogenic therapies. Periinterventional analgesic requirements were significantly lower for radioembolization procedures performed with G5 than WFI: 5 of 77 (6.5%) versus 29 of 77 (37.7%), P ≤ 0,001, respectively. Early stasis (defined as slowed antegrade flow, before total vascular stasis) occurred in 12 of 154 (7.8%) radioembolization procedures overall and was not different (P ≤ 0.229) between the 2 groups (4/77 [5.2%] vs. 8/77 [10.4%]).


CONCLUSIONS
Slow pulsatile administration of90Y-resin microspheres with WFI is associated with a low rate of stasis. Replacement of WFI with G5 significantly reduces the need for periprocedural analgesia. These data favor the use G5 for90Y-resin microsphere implantation in daily practice.
Department of Clinical Radiology, LMU University of Munich, Munich, Germany karolin.paprottka@med.lmu.de.
Karolin Johanna
KJ
Paprottka
Department of Nuclear Medicine, LMU University of Munich, Munich, Germany.
Sebastian
S
Lehner
Department of Nuclear Medicine, LMU University of Munich, Munich, Germany.
Wolfgang P
WP
Fendler
Department of Nuclear Medicine, LMU University of Munich, Munich, Germany.
Harun
H
Ilhan
Department of Nuclear Medicine, LMU University of Munich, Munich, Germany.
Axel
A
Rominger
Department of Clinical Radiology, LMU University of Munich, Munich, Germany.
Wieland
W
Sommer
Department of Clinical Radiology, LMU University of Munich, Munich, Germany.
Dirk A
DA
Clevert
Department of Hepatology, LMU University of Munich, Munich, Germany; and.
Mark
M
Op den Winkel
Department of Oncology, LMU University of Munich, Munich, Germany.
Volker
V
Heinemann
Department of Clinical Radiology, LMU University of Munich, Munich, Germany.
Philipp Marius
PM
Paprottka
D000368:Aged; D000700:Analgesics / Q000008:administration & dosage*; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods; D005947:Glucose / Q000008:administration & dosage* / Q000737:chemistry; D006801:Humans; D007262:Infusions, Intravenous / Q000009:adverse effects; D007267:Injections / Q000009:adverse effects; D008863:Microspheres; D010146:Pain / Q000209:etiology / Q000517:prevention & control*; D014677:Pharmaceutical Vehicles / Q000008:administration & dosage / Q000737:chemistry; D019275:Radiopharmaceuticals / Q000008:administration & dosage / Q000009:adverse effects / Q000737:chemistry; D012189:Retrospective Studies; D014867:Water / Q000008:administration & dosage* / Q000737:chemistry; D015021:Yttrium Radioisotopes / Q000008:administration & dosage* / Q000737:chemistry
D000700:Analgesics; D014677:Pharmaceutical Vehicles; D019275:Radiopharmaceuticals; D015021:Yttrium Radioisotopes; D014867:Water; D005947:Glucose
glucose 5% (G5); peri-procedural analgesia; radioembolization (RE); stasis rate; water for injection (WFI)