Efficacy and Safety of Deep Sedation in Percutaneous Radiofrequency Ablation for Hepatocellular Carcinoma

Koki Sato, Nobuhito Taniki, Ryo Kanazawa, Motonori Shimizu, Shigeto Ishii, Hideko Ohama, Masashi Takawa, Hiroaki Nagamatsu, Yasuharu Imai, Shuichiro Shiina

研究成果: Article

抄録

Introduction: Radiofrequency ablation (RFA) has been accepted as safe and effective for treating early-stage hepatocellular carcinoma (HCC). However, it often causes severe pain. Therefore, in this study, we performed RFA under deep sedation and investigated its efficacy and safety. Methods: We conducted a retrospective study including 511 HCC patients who received approximately 886 RFA treatments between December 2014 and November 2016 at our institution. Respiratory depression was defined as oxygen saturation of below 90%; and severe body movement was defined as movement caused by pain, which was managed by lowering the power of the generator. Factors associated with respiratory depression and severe body movement were examined via univariate and multivariate regression analyses. Results: Respiratory depression occurred in 15.3% of the patients and severe body movement in 26.5% of the patients. In the multivariate analysis, BMI (≥ 25 kg/m 2 , odds ratio [OR] = 1.75, P = 0.035) and longer ablation (≥ 10 min, OR = 2.59, P = 0.002) were significant respiratory depression-related factors. Male sex (OR = 2.02, P = 0.005), Child–Pugh class A (odds ratio = 1.96, P = 0.018), and longer ablation (≥ 10 min, OR = 3.03, P < 0.001) were significant factors related to severe body movement. Conclusion: Deep sedation for RFA can be performed safely and effectively. Higher BMI and longer ablation were risk factors for respiratory depression and male sex, Child–Pugh class A, and longer ablation were independent predictors of severe body movement during RFA under deep sedation.

元の言語English
ページ(範囲)344-354
ページ数11
ジャーナルAdvances in Therapy
36
発行部数2
DOI
出版物ステータスPublished - 2019 2 1
外部発表Yes

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Deep Sedation
Respiratory Insufficiency
Hepatocellular Carcinoma
Odds Ratio
Safety
Multivariate Analysis
Pain
Sex Ratio
Retrospective Studies
Regression Analysis
Oxygen

ASJC Scopus subject areas

  • Pharmacology (medical)

これを引用

Efficacy and Safety of Deep Sedation in Percutaneous Radiofrequency Ablation for Hepatocellular Carcinoma. / Sato, Koki; Taniki, Nobuhito; Kanazawa, Ryo; Shimizu, Motonori; Ishii, Shigeto; Ohama, Hideko; Takawa, Masashi; Nagamatsu, Hiroaki; Imai, Yasuharu; Shiina, Shuichiro.

:: Advances in Therapy, 巻 36, 番号 2, 01.02.2019, p. 344-354.

研究成果: Article

Sato, K, Taniki, N, Kanazawa, R, Shimizu, M, Ishii, S, Ohama, H, Takawa, M, Nagamatsu, H, Imai, Y & Shiina, S 2019, 'Efficacy and Safety of Deep Sedation in Percutaneous Radiofrequency Ablation for Hepatocellular Carcinoma', Advances in Therapy, 巻. 36, 番号 2, pp. 344-354. https://doi.org/10.1007/s12325-018-0865-z
Sato, Koki ; Taniki, Nobuhito ; Kanazawa, Ryo ; Shimizu, Motonori ; Ishii, Shigeto ; Ohama, Hideko ; Takawa, Masashi ; Nagamatsu, Hiroaki ; Imai, Yasuharu ; Shiina, Shuichiro. / Efficacy and Safety of Deep Sedation in Percutaneous Radiofrequency Ablation for Hepatocellular Carcinoma. :: Advances in Therapy. 2019 ; 巻 36, 番号 2. pp. 344-354.
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abstract = "Introduction: Radiofrequency ablation (RFA) has been accepted as safe and effective for treating early-stage hepatocellular carcinoma (HCC). However, it often causes severe pain. Therefore, in this study, we performed RFA under deep sedation and investigated its efficacy and safety. Methods: We conducted a retrospective study including 511 HCC patients who received approximately 886 RFA treatments between December 2014 and November 2016 at our institution. Respiratory depression was defined as oxygen saturation of below 90{\%}; and severe body movement was defined as movement caused by pain, which was managed by lowering the power of the generator. Factors associated with respiratory depression and severe body movement were examined via univariate and multivariate regression analyses. Results: Respiratory depression occurred in 15.3{\%} of the patients and severe body movement in 26.5{\%} of the patients. In the multivariate analysis, BMI (≥ 25 kg/m 2 , odds ratio [OR] = 1.75, P = 0.035) and longer ablation (≥ 10 min, OR = 2.59, P = 0.002) were significant respiratory depression-related factors. Male sex (OR = 2.02, P = 0.005), Child–Pugh class A (odds ratio = 1.96, P = 0.018), and longer ablation (≥ 10 min, OR = 3.03, P < 0.001) were significant factors related to severe body movement. Conclusion: Deep sedation for RFA can be performed safely and effectively. Higher BMI and longer ablation were risk factors for respiratory depression and male sex, Child–Pugh class A, and longer ablation were independent predictors of severe body movement during RFA under deep sedation.",
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T1 - Efficacy and Safety of Deep Sedation in Percutaneous Radiofrequency Ablation for Hepatocellular Carcinoma

AU - Sato, Koki

AU - Taniki, Nobuhito

AU - Kanazawa, Ryo

AU - Shimizu, Motonori

AU - Ishii, Shigeto

AU - Ohama, Hideko

AU - Takawa, Masashi

AU - Nagamatsu, Hiroaki

AU - Imai, Yasuharu

AU - Shiina, Shuichiro

PY - 2019/2/1

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N2 - Introduction: Radiofrequency ablation (RFA) has been accepted as safe and effective for treating early-stage hepatocellular carcinoma (HCC). However, it often causes severe pain. Therefore, in this study, we performed RFA under deep sedation and investigated its efficacy and safety. Methods: We conducted a retrospective study including 511 HCC patients who received approximately 886 RFA treatments between December 2014 and November 2016 at our institution. Respiratory depression was defined as oxygen saturation of below 90%; and severe body movement was defined as movement caused by pain, which was managed by lowering the power of the generator. Factors associated with respiratory depression and severe body movement were examined via univariate and multivariate regression analyses. Results: Respiratory depression occurred in 15.3% of the patients and severe body movement in 26.5% of the patients. In the multivariate analysis, BMI (≥ 25 kg/m 2 , odds ratio [OR] = 1.75, P = 0.035) and longer ablation (≥ 10 min, OR = 2.59, P = 0.002) were significant respiratory depression-related factors. Male sex (OR = 2.02, P = 0.005), Child–Pugh class A (odds ratio = 1.96, P = 0.018), and longer ablation (≥ 10 min, OR = 3.03, P < 0.001) were significant factors related to severe body movement. Conclusion: Deep sedation for RFA can be performed safely and effectively. Higher BMI and longer ablation were risk factors for respiratory depression and male sex, Child–Pugh class A, and longer ablation were independent predictors of severe body movement during RFA under deep sedation.

AB - Introduction: Radiofrequency ablation (RFA) has been accepted as safe and effective for treating early-stage hepatocellular carcinoma (HCC). However, it often causes severe pain. Therefore, in this study, we performed RFA under deep sedation and investigated its efficacy and safety. Methods: We conducted a retrospective study including 511 HCC patients who received approximately 886 RFA treatments between December 2014 and November 2016 at our institution. Respiratory depression was defined as oxygen saturation of below 90%; and severe body movement was defined as movement caused by pain, which was managed by lowering the power of the generator. Factors associated with respiratory depression and severe body movement were examined via univariate and multivariate regression analyses. Results: Respiratory depression occurred in 15.3% of the patients and severe body movement in 26.5% of the patients. In the multivariate analysis, BMI (≥ 25 kg/m 2 , odds ratio [OR] = 1.75, P = 0.035) and longer ablation (≥ 10 min, OR = 2.59, P = 0.002) were significant respiratory depression-related factors. Male sex (OR = 2.02, P = 0.005), Child–Pugh class A (odds ratio = 1.96, P = 0.018), and longer ablation (≥ 10 min, OR = 3.03, P < 0.001) were significant factors related to severe body movement. Conclusion: Deep sedation for RFA can be performed safely and effectively. Higher BMI and longer ablation were risk factors for respiratory depression and male sex, Child–Pugh class A, and longer ablation were independent predictors of severe body movement during RFA under deep sedation.

KW - Deep sedation

KW - Hepatocellular carcinoma

KW - Percutaneous radiofrequency ablation

KW - Respiratory depression

KW - Severe body movement

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