Non-Operating Room Anesthesia (NORA) for Ultrasound-Guided Liver Radiofrequency Ablation
Abstract
:1. Introduction
2. Materials and Methods
2.1. The Technique
2.2. Outcomes
2.3. Data and Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
ABCDE | Airway, Breathing, Circulation, Disability, Environment |
BCLC | Barcelona Clinic Liver Cancer |
CRLM | Colorectal liver metastases |
CT | Computed tomography |
ECOG | Eastern Cooperative Oncologic Group Performance Status |
ESMO | European Society for Medical Oncology |
HCC | Hepatocellular carcinoma |
i.v. | Intravenous |
MASLD | Metabolic-Dysfunction Associated Steatotic Liver Disease |
MWA | Microwave ablation |
NORA | Non-operating room anesthesia |
RFA | Radiofrequency ablation |
TACE | Transarterial chemoembolization |
US | Ultrasound |
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Total pts (n = 35) | HCC (n = 26) | |
---|---|---|
Age, years (mean (SD)) | 71.5 (9.5) | 70.8 (8.3) |
Gender, male (n (%)) | 28 (80) | 21 (80.8) |
BMI (mean (SD)) | 28.5 (5.2) | 29.1 (5.2) |
HCC (n (%)) | 26 (74.3) | |
Metastasis (n (%)) | 9 (25.7) | |
Colon cancer (n (%)) | 6 (66.7) | |
Gastric cancer (n (%)) | 3 (33.3) | |
Comorbidities | ||
Obesity (n (%)) | 12 (34.3) | 12 (46.1) |
Ischemic heart disease (n (%)) | 6 (17.1) | 5 (19.2) |
Hypertension (n (%)) | 16 (45.7) | 13 (50) |
Dyslipidemia (n (%)) | 3 (8.5) | 3 (11.5) |
Diabetes mellitus (n (%)) | 11 (31.4) | 9 (34.6) |
COPD/asthma (n (%)) | 4 (11.4) | 3 (11.5) |
Atrial fibrillation (n (%)) | 4 (11.4) | 4 (15.4) |
Previous treatment (n (%)) | 13 (37.1) | |
Liver resection (n (%)) | 5 (38.5) | |
RFA (n (%)) | 7 (53.8) | |
TACE (n (%)) | 1 (7.7) | |
Antiplatelet therapy (n (%)) | 7 (20%) | |
Anticoagulant therapy (n (%)) | 6 (17.1) | |
Vitamin K antagonists (n (%)) | 2 (33.3) | |
DOACs (n (%)) | 2 (33.3) | |
Heparins (n (%)) | 2 (33.3) | |
Etiology of liver disease | ||
ALD (n (%)) | 6 (23.1) | |
MASLD (n (%)) | 12 (46.1) | |
AIH (n (%)) | 1 (3.8) | |
PBC (n (%)) | 1 (3.8) | |
PSC (n (%)) | 0 (0) | |
HBV infection (n (%)) | 4 (15.4) | |
HCV infection (n (%)) | 9 (34.6) | |
Cryptogenic (n (%)) | 1 (3.8) | |
Mixed etiology (n (%)) | 9 (34.6) | |
Chronic liver disease/cirrhosis (n (%)) | 24 (92.3) | |
Child–Pugh score | ||
A5 (n (%)) | 19 (73.1) | |
A6 (n (%)) | 4 (15.4) | |
B7 (n (%)) | 2 (7.7) | |
B8 (n (%)) | 1 (3.8) | |
MELD-Na (mean (SD)) | 9.2 (2.4) | |
Alpha-FP value, ng/mL (mean (SD)) | 12 (14.5) | |
Portal vein thrombosis (n (%)) | 2 (7.7) |
RFA | |
---|---|
Tumor number | |
1 (n (%)) | 32 (91.4) |
2 (n (%)) | 3 (8.6) |
Tumor location | |
S1 (n (%)) | 0 (0) |
S2 (n (%)) | 1 (2.6) |
S3 (n (%)) | 4 (10.5) |
S4 (n (%)) | 6 (15.8) |
S5 (n (%)) | 3 (7.9) |
S6 (n (%)) | 9 (23.7) |
S7 (n (%)) | 9 (23.7) |
S8 (n (%)) | 6 (15.8) |
Tumor size, mm (mean (SD)) | 21 (10.1) |
Size of needle’s tip | |
2 cm (n, %) | 6 (15.8) |
3 cm (n, %) | 32 (84.2) |
Artificial ascites—subcapsular or subphrenic lesions (n (%)) | 4 (10.5) |
Duration of ablation time, min (mean (SD)) | 8.8 (3.1) |
Peak power, W (mean (SD)) | 152.7 (22.2) |
Anesthesia | |
Sedation agents | |
Propofol + fentanyl (n (%)) | 35 (100%) |
Insertion of the needle with the patient awake (n (%)) | 35 (92.1) |
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Share and Cite
Jung, C.F.M.; Liverani, E.; Binda, C.; Cristofaro, L.; Gori, A.; Alemanni, L.V.; Sartini, A.; Coluccio, C.; Gibiino, G.; Petraroli, C.; et al. Non-Operating Room Anesthesia (NORA) for Ultrasound-Guided Liver Radiofrequency Ablation. Diagnostics 2024, 14, 1783. https://doi.org/10.3390/diagnostics14161783
Jung CFM, Liverani E, Binda C, Cristofaro L, Gori A, Alemanni LV, Sartini A, Coluccio C, Gibiino G, Petraroli C, et al. Non-Operating Room Anesthesia (NORA) for Ultrasound-Guided Liver Radiofrequency Ablation. Diagnostics. 2024; 14(16):1783. https://doi.org/10.3390/diagnostics14161783
Chicago/Turabian StyleJung, Carlo Felix Maria, Elisa Liverani, Cecilia Binda, Ludovica Cristofaro, Alberto Gori, Luigina Vanessa Alemanni, Alessandro Sartini, Chiara Coluccio, Giulia Gibiino, Chiara Petraroli, and et al. 2024. "Non-Operating Room Anesthesia (NORA) for Ultrasound-Guided Liver Radiofrequency Ablation" Diagnostics 14, no. 16: 1783. https://doi.org/10.3390/diagnostics14161783