Novel multimodal analgesic regimen for perioperative pain management after hepatic artery infusion chemotherapy in patients with advanced hepatocellular carcinoma  

作　　者：Jing Yan Rui An Jing-Jing Wang Min Wang Qi Zhao Shen Zhao Jian Xu 

机构地区：[1]Department of Interventional Surgery Center,Xijing Hospital,The Fourth Military Medical University,Xi’an 710032,Shaanxi Province,China

出　　处：《World Journal of Gastrointestinal Surgery》2025年第4期271-282,共12页世界胃肠外科杂志(英文)

基　　金：Supported by Beijing Medical Award Foundation of China,No.YXJL-2023-0638-0048.

摘　　要：BACKGROUND 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.AIM To provide patients with a more comprehensive and effective pain management strategy.METHODS A total of 100 patients with primary HCC who underwent HAIC were randomly assigned to a control group(n=50)and a multimodal group(n=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.RESULTS 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(P<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(P<0.05).Patient satisfaction was also significantly higher in the multimodal group than in the control group(P<0.05).CONCLUSION 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.

关 键 词：Advanced hepatocellular carcinoma Hepatic artery infusion chemotherapy Multimodal analgesia regimen Postoperative pain Pain improvement 

分 类 号：R73[医药卫生—肿瘤]