Assessment of Pain Severity after Radiofrequency Ablation in Patients with Hepatocellular Carcinoma

OBJECTIVE: To find the incidence of moderate to severe pain after percutaneous radiofrequency ablation (RFA) in patients with hepatocellular carcinoma and to identify the factors affecting unwanted pain scores.

MATERIAL AND METHOD: This prospective study was conducted on patients who underwent percutaneous radiofrequency ablation under intravenous sedation and local anesthesia. The pain scores were obtained from 18 to 24 hours after the procedure. Moderate to severe pain was defined as a value of 4 or more on the Numeric Rating Scale (NRS). Data on patients' factors, tumor characteristics, procedural factors, anesthetic management, postoperative treatment and perioperative complication was collected

RESULTS: A total of 190 patients were enrolled, comprised of 134 men (70.5%) and 56 women (29.5%). The mean age of the patients was 63.3 ± 11.1 years. The incidence of moderate to severe pain on movement (an NRS value equal to or greater than 4) was 11.6% (22 out of 190 patients). A univariate analysis revealed that two factors--patients with multiple tumors (more than two tumors), and an ablation time of greater than 30 minutes--seemed to be related to an NRS equal to or greater than 4. Nevertheless, after entering those two factors into a multiple regression model, neither factor was associated with the moderate to severe pain scores.

CONCLUSION: The incidence of undesired pain scores after percutaneous radiofrequency ablation in our institution was around 10%, and the rate of complication was very low.