Yan Jing, An Rui, Wang Jing-Jing, Wang Min, Zhao Qi, Zhao Shen, Xu Jian
Department of Interventional Surgery Center, Xijing Hospital, The Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China.
World J Gastrointest Surg. 2025 Apr 27;17(4):101439. doi: 10.4240/wjgs.v17.i4.101439.
Hepatic artery infusion chemotherapy (HAIC) is a widely used local therapeutic approach for intermediate to advanced-stage hepatocellular carcinoma (HCC), exhibiting considerable efficacy. However, the prevalence of postoperative pain highlights the importance of pain management. Owing to the limitations inherent in existing pain management strategies, this study investigates and assesses the analgesic effectiveness of a multimodal treatment protocol in mitigating pain after HAIC procedures.
To provide patients with a more comprehensive and effective pain management strategy.
A total of 100 patients with primary HCC who underwent HAIC were randomly assigned to a control group ( = 50) and a multimodal group ( = 50). Baseline characteristics and perioperative data were collected. Upon enrollment, patients in the multimodal group received parecoxib (40 mg) 30 minutes before HAIC, followed by 48 hours of patient-controlled analgesia with sufentanil. In contrast, the control group underwent standard preoperative preparation (psychological support) and received dezocine (5 mg) intraoperatively, with intravenous flurbiprofen (100 mg) administered every 12 hours for 48 hours postoperatively.
Compared to the control group, the multimodal analgesia group exhibited significantly lower resting and movement visual analog scale pain scores at postoperative 0, 2, 4, 6, and 12 hours ( < 0.05). Furthermore, the multimodal group experienced a reduced incidence of postoperative nausea and vomiting, as well as a lower overall frequency of adverse events, compared to the control group ( < 0.05). Patient satisfaction was also significantly higher in the multimodal group than in the control group ( < 0.05).
Our study demonstrates that multimodal analgesia is effective in reducing postoperative pain, minimizing adverse reactions, and improving patient satisfaction in HCC patients undergoing HAIC. This approach provides valuable clinical strategies for optimizing pain management in this patient population.
肝动脉灌注化疗（HAIC）是一种广泛应用于中晚期肝细胞癌（HCC）的局部治疗方法，具有显著疗效。然而，术后疼痛的普遍存在凸显了疼痛管理的重要性。由于现有疼痛管理策略存在固有局限性，本研究调查并评估了一种多模式治疗方案在减轻HAIC术后疼痛方面的镇痛效果。
为患者提供更全面有效的疼痛管理策略。
总共100例接受HAIC的原发性肝癌患者被随机分为对照组（n = 50）和多模式组（n = 50）。收集基线特征和围手术期数据。入组时，多模式组患者在HAIC前30分钟接受帕瑞昔布（40毫克），随后进行48小时的舒芬太尼患者自控镇痛。相比之下，对照组接受标准术前准备（心理支持），术中接受地佐辛（5毫克），术后48小时每12小时静脉注射氟比洛芬（100毫克）。
与对照组相比，多模式镇痛组在术后0、2、4、6和12小时的静息和运动视觉模拟评分疼痛得分显著更低（P < 0.05）。此外，与对照组相比，多模式组术后恶心呕吐的发生率降低，不良事件的总体发生率也更低（P < 0.05）。多模式组患者的满意度也显著高于对照组（P < 0.05）。
我们的研究表明，多模式镇痛在减轻接受HAIC的HCC患者术后疼痛、减少不良反应和提高患者满意度方面是有效的。这种方法为优化该患者群体的疼痛管理提供了有价值的临床策略。
