Effects of multimodal analgesia based on enhanced recovery after surgery in patients with HCC underwent TACE

doi:10.3877/cma.j.issn.2095-5782.2021.02.018

Abstract

Abstract:

Objective

To evaluate the effects of multimodal analgesia which was based on the idea of enhanced recovery after surgery (ERAS) in hepatocellular carcinoma patients who underwent transarterial chemoembolization (TACE).

Methods

Sixty eight patients underwent TACE from Oct. to Dec. in 2020 were in the prospective control study, and were divided into two groups randomly, the ERAS group (n = 34) and the control group (n = 34). The pain scores (VAS) and the incidence of postembolization syndrome after TACE and the value of cost-effectiveness were recorded.

Results

There was no difference between the two groups before operation (P > 0.05). Compared with the ERAS group, the VAS in the control group were higher at 2, 4 and 6 h after TACE significantly (P < 0.05). The differences of nausea/vomiting between the two groups were statistically significant (Z =-2.139, P < 0.05). Cost-effectiveness analysis showed the ERAS group proved to be more economical (P < 0.05).

Conclusions

Multimodal analgesia could relieve pain after TACE more effectively, decrease adverse effects and be more economical. Therefore, Multimodal analgesiais worthy of clinical promotion and application.

Key words: Enhanced recovery after surgery (ERAS), Multimodal analgesia, TACE

Chong Peng, Fangyan Lu, Junhui Sun. Effects of multimodal analgesia based on enhanced recovery after surgery in patients with HCC underwent TACE[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2021, 09(02): 215-219.

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References 17

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项目		ERAS组（n = 34）	对照组（n = 34）	P值
年龄（岁）		62.3 ± 9.4	60.8 ± 11.5	> 0.05
性别（例）				> 0.05
	男	24	26
	女	10	8
BMI（kg/m²）		21.9±2.8	22.1 ± 2.4	> 0.05
Child-Pugh分级				> 0.05
	A	26	25
	B	8	9
手术时长（min）		33.2 ± 16.4	29.2 ± 15.6	> 0.05
甲胎蛋白（例）				> 0.05
阳性（异常）		28	29
HBsAg阳性		27	28	> 0.05
血管癌栓		22	19	> 0.05
碘化油用量（mL）		5.5 ± 3.2	4.8 ± 2.7	> 0.05
肿瘤位置				> 0.05
	单侧肝叶	30	29
	左右肝叶	1	0
	其他（无肿瘤）	3	4
肿瘤大小（cm）		5.2 ± 2.9	5.6 ± 3.0	> 0.05
肿瘤离肝包膜（cm）		3.8 ± 1.9	3.4 ± 1.2	> 0.05
术前VAS评分		0.03 ± 0.19	0	> 0.05

项目		ERAS组（n = 34）	对照组（n = 34）	P值
年龄（岁）		62.3 ± 9.4	60.8 ± 11.5	> 0.05
性别（例）				> 0.05
	男	24	26
	女	10	8
BMI（kg/m²）		21.9±2.8	22.1 ± 2.4	> 0.05
Child-Pugh分级				> 0.05
	A	26	25
	B	8	9
手术时长（min）		33.2 ± 16.4	29.2 ± 15.6	> 0.05
甲胎蛋白（例）				> 0.05
阳性（异常）		28	29
HBsAg阳性		27	28	> 0.05
血管癌栓		22	19	> 0.05
碘化油用量（mL）		5.5 ± 3.2	4.8 ± 2.7	> 0.05
肿瘤位置				> 0.05
	单侧肝叶	30	29
	左右肝叶	1	0
	其他（无肿瘤）	3	4
肿瘤大小（cm）		5.2 ± 2.9	5.6 ± 3.0	> 0.05
肿瘤离肝包膜（cm）		3.8 ± 1.9	3.4 ± 1.2	> 0.05
术前VAS评分		0.03 ± 0.19	0	> 0.05

时间	ERAS组（n = 34）	对照组（n = 34）	P值
TACE术中	1.35 ± 1.87	0.94 ± 1.54	0.384
T0	1.01 ± 1.90	1.30 ± 1.55	0.540
T2	0.94 ± 1.52	2.06 ± 2.44	0.012 < 0.05
T4	0.80 ± 1.28	1.93 ± 2.43	0.034 < 0.05
T6	0.66 ± 1.13	1.48 ± 2.08	0.025 < 0.05
T12	0.64 ± 1.11	1.10 ± 1.47	0.140
T24	0.25 ± 0.61	0.45 ± 0.72	0.180

时间	ERAS组（n = 34）	对照组（n = 34）	P值
TACE术中	1.35 ± 1.87	0.94 ± 1.54	0.384
T0	1.01 ± 1.90	1.30 ± 1.55	0.540
T2	0.94 ± 1.52	2.06 ± 2.44	0.012 < 0.05
T4	0.80 ± 1.28	1.93 ± 2.43	0.034 < 0.05
T6	0.66 ± 1.13	1.48 ± 2.08	0.025 < 0.05
T12	0.64 ± 1.11	1.10 ± 1.47	0.140
T24	0.25 ± 0.61	0.45 ± 0.72	0.180

栓塞综合征		ERAS组（n = 34）	常规组（n = 34）	P值
NVSD				0.032 < 0.05
	0级	18（53）	8（24）
	1级	11（32）	14（41）
	2级	5（15）	12（35）
发热		24（71）	22（65）	0.544
其他		1（3）	1（3）

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