Optimized nerve block techniques while performing percutaneous hepatic ablation: Literature review and practical use.

Area of Science:

• Interventional Radiology
• Oncology
• Pain Management

Background:

• Percutaneous thermal ablation (RFA, MWA) is standard for liver malignancies but causes significant pain.
• Increased ablation intensity necessitates more sedation or general anesthesia, posing risks and increasing costs.
• Alternatives to general anesthesia are needed, especially considering infection transmission risks.

Purpose of the Study:

• To outline and illustrate the use of nerve block/regional anesthesia techniques for percutaneous hepatic thermal ablation.
• To demonstrate the practical application of these blocks in managing peri-procedural pain.
• To highlight the benefits of regional anesthesia in improving patient outcomes and procedural efficiency.

Main Methods:

• Utilizing upper abdominal regional nerve blocks (splanchnic, celiac, hepatic hilar) for peri-procedural pain control.
• Incorporating hydrodissection with tumescent anesthesia alongside nerve blocks.
• Applying these techniques in a high-volume ablation center setting.

Main Results:

• Dramatic decrease in administered sedatives during procedures.
• Significant reduction in patient discomfort during localization and ablation.
• Decreased post-procedure pain, faster discharge times, and reduced procedural time.

Conclusions:

• Regional anesthesia techniques, including nerve blocks and hydrodissection, effectively manage pain during percutaneous hepatic thermal ablation.
• These methods reduce the need for sedation and general anesthesia, enhancing patient safety and recovery.
• The application of regional anesthesia offers practical benefits for interventional radiology procedures, improving efficiency and patient experience.