[Neuroleptanalgesia in patients undergoing percutaneous, ultrasound-directed radiofrequency for primary or secondary, single or multiple hepatic neoplasms]

The use of percutaneous ultrasound-directed radiofrequency is a recent technique in non-surgical therapy of some neoplastic liver lesions. Purpose of this study is to demonstrate that the use of a narcosis-free analgesia allows to perform this procedure, which is generally painful and badly by the patient.

We treated 51 patients for a total of 126 procedures; the first 17 patients underwent a mono- or multipolar technique with uncooled electrodes, while the remaining 34 patients have been treated with double perfusion lumen electrodes with the chance of tipcooling. We used diidrobenzoperydol and fentanyl with a mean dose for each session of 209 micrograms for the first 17 patients and 109 micrograms for the other 34.

Using VAS, we obtained a painless procedure in 42 patients and mild-pain sensations in 9 patients, while one hour after the procedure painless or light-pain sensation were observed in 49 patients and mild-pain in 2 patients, which required the use of FANS i.v. At discharge, all patients were pain-free or with very light pain sensation. We reduced the intra-hospital observation of patients from 5 to 3 hours, once the technique has been modified. 4 patients complained about nausea and 1 of these emesis. We did not observe any cardiovascular, respiratory and/or neurological complications.

The use of neuroleptanalgesia allowed us to perform the described procedure with a good feeling by the patients.