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Iezzi R, Posa A, Caputo CT, De Leoni D, Sbaraglia F, Rossi M, Tortora G, Tagliaferri L, Valentini V, Colosimo C. Safety and Feasibility of Analgosedation for Electrochemotherapy of Liver Lesions. Life (Basel) 2023; 13:life13030631. [PMID: 36983788 PMCID: PMC10051269 DOI: 10.3390/life13030631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 02/11/2023] [Accepted: 02/23/2023] [Indexed: 03/21/2023] Open
Abstract
Interventional Oncology treatments grant low-risk mini-invasive alternatives to surgery for cancer patients. Percutaneous ablative therapies represent a cornerstone for treatment of liver cancer patients. Among these, a newly emerging one is represented by electrochemotherapy. Improvements in analgesia and sedation can nowadays offer optimal support for ablative procedures, serving as a valid alternative to general anesthesia. The intention of this retrospective monocentric study is to report our preliminary experience on feasibility and safety of electrochemotherapy for treatment of complex liver tumors unfit for thermal ablation, using analgosedation instead of general anesthesia. Five patients were enrolled in the study, undergoing electrochemotherapy under analgosedation. Mean procedural time and hospitalization time were recorded. Immediate post-procedural cone-beam CT showed complete coverage of the lesion without complications. One-month CT examination showed an overall response rate of 100% (four complete responses, one partial response). Electrochemotherapy under analgosedation seems to be a safe, feasible, and effective option for liver cancer patients not amenable to other ablative techniques.
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Affiliation(s)
- Roberto Iezzi
- Department of Diagnostic Imaging, Oncologic Radiotherapy and Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy
- Correspondence: (R.I.); (A.P.)
| | - Alessandro Posa
- Department of Diagnostic Imaging, Oncologic Radiotherapy and Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy
- Correspondence: (R.I.); (A.P.)
| | - Cosimo Tommaso Caputo
- Department of Anesthesia and Intensive Care, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Davide De Leoni
- Department of Diagnostic Imaging, Oncologic Radiotherapy and Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Fabio Sbaraglia
- Department of Anesthesia and Intensive Care, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Marco Rossi
- Department of Anesthesia and Intensive Care, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Giampaolo Tortora
- Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Luca Tagliaferri
- Department of Diagnostic Imaging, Oncologic Radiotherapy and Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Vincenzo Valentini
- Department of Diagnostic Imaging, Oncologic Radiotherapy and Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy
| | - Cesare Colosimo
- Department of Diagnostic Imaging, Oncologic Radiotherapy and Hematology, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy
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Prospective Analysis of the Pattern and Risk for Severe Vital Sign Changes During Percutaneous Radiofrequency Ablation of the Liver Under Opioid Analgesia. AJR Am J Roentgenol 2010; 194:799-808. [DOI: 10.2214/ajr.09.3044] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Choi YS. Monitored Anesthesia Care and Sedation/Analgesia Outside the Operating Room. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2009. [DOI: 10.5124/jkma.2009.52.6.592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Yong-Seon Choi
- Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Korea.
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Patatas K, Koukkoulli A. The use of sedation in the radiology department. Clin Radiol 2008; 64:655-63. [PMID: 19520209 DOI: 10.1016/j.crad.2008.11.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2008] [Revised: 11/09/2008] [Accepted: 11/14/2008] [Indexed: 10/21/2022]
Abstract
The use of intravenous sedation and analgesia in patients undergoing interventional diagnostic and therapeutic procedures is increasing. Sedation by non-anaesthetists is considered to be safe, provided that they have received adequate training and have the necessary equipment, facilities, and personnel. This article aims to increase awareness of the safe use of sedative drugs in radiology and provide a practical guideline for minimal and moderate sedation.
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Affiliation(s)
- K Patatas
- Radiology Academy, Leeds Teaching Hospitals NHS Trust, Leeds General Infirmary, Leeds, UK.
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