Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands.
School for Cardiovascular Diseases (CARIM), Maastricht University, Maastricht, The Netherlands.
Cardiovasc Intervent Radiol. 2024 Nov;47(11):1485-1492. doi: 10.1007/s00270-024-03851-5. Epub 2024 Sep 4.
Literature shows differences in pain experiences between sexes. The exact influence of thermal liver ablation on experienced pain is still not well-known. This study aims to investigate the maximum pain intensity at the recovery between men and women after percutaneous thermal liver ablation.
Patients treated with percutaneous thermal liver ablation (radiofrequency or microwave ablation) in Maastricht University Medical Center + between 2018 and 2022 for primary or secondary liver tumors were included retrospectively. Outcomes included maximum numerical rating scale (NRS, scale:0-10) score at the recovery room, prevalence of post-procedural pain (defined as NRS score ≥ 4), duration of anesthesia, length of stay at recovery, and complications. Regression analyses were adjusted for age, ASA-score, BMI, tumor type, maximum diameter of lesion, chronic pain in patients' history, and history of psychological disorder.
183 patients were included of which 123 men (67%). Results showed higher average maximum NRS scores in women patients compared to men (mean:3.88 versus 2.73), but not after adjustments (aß:0.75, 95%CI:-0.13-1.64). Women suffered more from acute post-procedural pain (59% versus 35%; aOR:2.50, 95%CI:1.16-5.39), and needed analgesics more often at the recovery room (aOR:2.43, 95%CI:1.07-5.48) compared to men. NRS score at recovery arrival did not significantly differ (aß:0.37, 95%CI:-0.48-1.22). No differences were seen in the length of stay at the recovery, duration of anesthesia, procedure time, and complication rate. Location of the tumor (subcapsular or deep), total tumors per patient, and distinction between primary and secondary tumors had no influence on the NRS.
This retrospective single-center study shows higher post-procedural pain rates after thermal liver ablation in women, resulting in higher analgesics use at the recovery room. The results suggest considering higher dosage of analgesics during thermal liver ablation in women to reduce post-procedural pain. LEVEL OF EVIDENCE 3: Non-controlled retrospective cohort study.
文献表明男女之间的疼痛体验存在差异。热消融治疗对疼痛的影响尚不清楚。本研究旨在探讨男女经皮热肝消融治疗后恢复室期间最大疼痛强度。
回顾性纳入 2018 年至 2022 年在马斯特里赫特大学医学中心接受经皮热肝消融（射频或微波消融）治疗的原发性或继发性肝肿瘤患者。主要结局为恢复室时的最大数字评分量表（NRS，范围：0-10）评分、术后疼痛发生率（定义为 NRS 评分≥4）、麻醉持续时间、恢复室停留时间和并发症。回归分析调整了年龄、ASA 评分、BMI、肿瘤类型、病变最大直径、患者既往慢性疼痛、既往心理障碍史。
共纳入 183 例患者，其中男性 123 例（67%）。结果显示女性患者的平均最大 NRS 评分高于男性（均值：3.88 比 2.73），但调整后无差异（β：0.75，95%CI：-0.13-1.64）。女性患者更易发生急性术后疼痛（59%比 35%；aOR：2.50，95%CI：1.16-5.39），在恢复室需要更多镇痛药物（aOR：2.43，95%CI：1.07-5.48）。恢复室到达时的 NRS 评分无显著差异（β：0.37，95%CI：-0.48-1.22）。两组患者在恢复室停留时间、麻醉持续时间、手术时间和并发症发生率方面无差异。肿瘤位置（包膜下或深部）、每位患者的肿瘤总数以及原发性和继发性肿瘤的区分对 NRS 无影响。
本回顾性单中心研究表明，女性经皮热肝消融治疗后术后疼痛发生率较高，导致恢复室使用更多镇痛药物。结果提示在女性热肝消融治疗中考虑使用更高剂量的镇痛药以减轻术后疼痛。证据等级 3：非对照回顾性队列研究。
