Different effects of oxycodone and remifentanil in patients undergoing ultrasound-guided percutaneous radiofrequency ablation of hepatic cancer: a randomized trial
Authors Wu J, Lu Y, Cao X
Received 12 October 2018
Accepted for publication 12 December 2018
Published 18 January 2019 Volume 2019:13 Pages 365—372
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Anastasios Lymperopoulos
Junbei Wu1,* Yunhong Lu2,* Xiaofei Cao1
1Department of Anesthesiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China; 2Department of Anesthesiology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
*These authors contributed equally to this work
Background: Percutaneous radiofrequency ablation (RFA) is a recently introduced alternative technique for the treatment of hepatic cancer. Anesthesia is required for RFA of hepatic cancer to achieve patient comfort and immobilization during this painful procedure. The purpose of this study was to investigate the analgesic efficacy and evaluate the safety of a single intravenous injection of oxycodone hydrochloride for this procedure.
Patients and methods: A total of 120 American Society of Anesthesiologists class I–II grade patients for elective ultrasound-guided percutaneous RFA were enrolled in this randomized controlled trial. Patients were randomized (1:1) to receive either a single intravenous injection of oxycodone (group O) or continuous infusion of remifentanil (group R). Both groups received the continuous infusion of dexmedetomidine for sedation. Visual analog scale (VAS), rescue analgesic, and side effects were checked during the periprocedural period. In addition, patient and oncologist satisfaction on a scale of 1–5 were determined.
Results: VAS score in group O was significantly lower than in group R at 1, 2, and 3 hours after RFA, and patients in group O required analgesics significantly later and less doses in the first 24 hours after RFA. The occurrence of unwanted body movements was significantly lower in group O. We found no complications including allergic reaction, excessive sedation, and chest wall rigidity in all patients. The patient satisfaction score was significantly higher in group O than that in group R.
Conclusion: Ultrasound-guided percutaneous RFA for hepatic cancer can be completed both with continuous infusion of remifentanil or a single intravenous injection of oxycodone. However, oxycodone hydrochloride provides better patient experience with higher satisfactory score and less unwanted body movements, relieves post-procedural pain better, and is not associated with an increase in adverse effects.
Keywords: analgesia, oxycodone, hepatic cancer, radiofrequency ablation
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