Sezgin Orhan, Yaras Serkan, Ates Fehmi, Altintas Engin, Saritas Bunyamin
Department of Gastroenterology, Mersin University, Mersin, Turkey.
Euroasian J Hepatogastroenterol. 2017 Jul-Dec;7(2):146-149. doi: 10.5005/jp-journals-10018-1236. Epub 2017 Sep 29.
Percutaneous needle liver biopsy (PLB) is frequently associated with pain and anxiety. This may discourage the patients for biopsy, and rebiopsies, if needed. We planned a study to investigate the efficacy of additional analgesia or sedation for PLB.
The study has been designed as a single-center, prospective study. The PLB was planned for 18- to 65-year-old consecutive patients who were included in the study. The patients were divided into three premedication groups as control, Meperidine, and Midazolam. Hospital Anxiety and Depression Scale (HADS) was used to measure each subject's anxiety level. Fifteen minutes before the biopsy, 1 mL 0.9% NaCl subcutaneously (sc), 1 mg/kg (max 100 mg) Meperidine sc, or 0.1 mg/kg (max 5 mg) Midazolam intravenously was administered to patients respectively. Then PLB was done with 16 G Menghini needle. The day after, the patients were asked about feelings regarding biopsy.
Groups were similar by gender and age. The HADS scores prior to PLB and on visual analog scale (VAS, 1-10 points) score during PLB were similar. In the three groups, 7, 12, and 7 patients, respectively, experienced no pain. Other patients explained pain as mild or moderate or severe. The number of patients who agreed for possible rebiopsy was higher in Meperidine and Midazolam groups than in the control group.
Premedication with Meperidine or Midazolam in PLB would improve patients' tolerance, comfort, and attitude against a possible repeat PLB. Sezgin O, Yaras S, Ates F, Altintas E, Saritas B. Effectiveness of Sedoanalgesia in Percutaneous Liver Biopsy Premedication. Euroasian J Hepato-Gastroenterol 2017;7(2):146-149.
经皮肝穿刺活检(PLB)常伴有疼痛和焦虑。这可能会使患者不愿接受活检,以及在需要时不愿接受再次活检。我们计划开展一项研究,以调查额外镇痛或镇静对经皮肝穿刺活检的效果。
本研究设计为单中心前瞻性研究。计划对年龄在18至65岁的连续纳入研究的患者进行经皮肝穿刺活检。患者被分为三个术前用药组,即对照组、哌替啶组和咪达唑仑组。采用医院焦虑抑郁量表(HADS)来测量每个受试者的焦虑水平。在活检前15分钟,分别给患者皮下注射1毫升0.9%氯化钠溶液、1毫克/千克(最大100毫克)哌替啶或静脉注射0.1毫克/千克(最大5毫克)咪达唑仑。然后用16G Menghini针进行经皮肝穿刺活检。术后第二天,询问患者对活检的感受。
各组在性别和年龄方面相似。经皮肝穿刺活检前的医院焦虑抑郁量表(HADS)评分以及活检过程中的视觉模拟量表(VAS,1至10分)评分相似。在三组中,分别有7例、12例和7例患者未感到疼痛。其他患者将疼痛描述为轻度、中度或重度。哌替啶组和咪达唑仑组中同意可能进行再次活检的患者数量高于对照组。
经皮肝穿刺活检术前使用哌替啶或咪达唑仑进行预处理可提高患者的耐受性、舒适度以及对可能的再次经皮肝穿刺活检的接受度。塞兹金·O、亚拉斯·S、阿泰什·F、阿尔廷塔斯·E、萨里塔斯·B。镇静镇痛在经皮肝穿刺活检术前用药中的有效性。《欧亚肝脏胃肠病学杂志》2017年;7(2):146 - 149。