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Hilar nerve block for percutaneous liver tumor ablation
Jeremy Lok Wei1, Carmen Chi Min Cho1, Wing Chung Law1
1Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Hong Kong SAR, China.
Purpose:
Hilar nerve block has been recently described as a method of pain relief during percutaneous liver tumor ablation. We aim to evaluate the efficacy and safety of hilar nerve block.
Methods:
In this retrospective cohort study, all patients who underwent image-guided percutaneous liver ablation with and without hilar nerve block from November 2022 to July 2024 in our institution were reviewed. Outcomes including technical success, complications, pain scores, intravenous analgesia and sedation requirements were compared between the nerve block and control groups.
Results:
Thirty patients were included in the nerve block group and 33 patients were included in the control group. The nerve block group experienced less pain during ablation compared to the control group, both overall (mean pain score 3.9 vs 5.5 respectively, p = 0.018) and within the non-subcapsular tumor subgroup (mean pain score 3.5 vs 5.3 respectively, p = 0.018). The nerve block group required lower doses of fentanyl compared to the control group (mean dose 17.5 µg vs 35.6 µg, p = 0.001). Twelve patients in the nerve block group did not require any intravenous analgesia.
Conclusions:
Hilar nerve block is a safe and effective technique for pain relief during percutaneous liver tumor ablation, which can lower the requirement for intravenous analgesics.
