Thoracic paravertebral block for the anesthetic management of percutaneous radiofrequency ablation of liver tumors.

Background and Aims: Percutaneous radiofrequency ablation (PRFA) is a minimally invasive treatment for hepatic tumors. We assessed and compared the efficacy of right thoracic paravertebral block (TPVB) with that of local anesthetic infiltration for the anesthetic management of PRFA of liver tumors.

Material and Methods: Sixty patients with hepatic tumors aged 50-80 years were randomly allocated into two groups. Group I received local anesthetic infiltration along the path of the ablation device with sedation. Group II received right TPVB at the level T7 and T9 with sedation. The pain was assessed using visual analog scale (VAS) at 1 min and then every 5 min during PRFA procedure, on admission, and discharge from the post-PRFA observation area. The total dose of rescue analgesia during PRFA procedure, number of patients requiring general anesthesia, patient and radiologist satisfaction were reported.

Results: VAS was significantly lower in group II than group I during and after PRFA procedure ( P < 0.05). General anesthesia was administered in 7 patients in group I, whereas no patient required general anesthesia in group II ( P < 0.05). Patient and radiologist satisfaction were significantly higher in group II compared to group I ( P < 0.05). There were no significant complications in group II compared to group I ( P > 0.05).

Conclusions: Right TPVB with sedation is an effective and safe anesthetic technique for the management of PRFA procedure of hepatic tumors. It is more effective than local anesthesia with sedation in relieving pain during PRFA procedure of hepatic tumors.