Transcatheter administration of buffered Lidocaine for pain relief due to transarterial chemoembolization for HCC

PurposeTo assess the efficacy of intra-arterial Lidocaine on post-procedural pain and on length of hospital stay in hepatocellular carcinoma (HCC) patients undergoing chemoembolization.Materials and methodsThirty-nine transarterial chemoembolization (TACE) procedures were carried out for 21 consecutive patients (19M, 2F, age range 52–78).This is a prospective randomized controlled study. Lidocaine was used in 20 TACE and normal saline in 19 TACE. Visual analog scoring was used to assess pain (VAS).ResultsPatients’ demographic criteria, Child Pugh, tumor size and doses of chemotherapeutic emulsion and amount of used PV particles were not statistically significantly different between both groups. Average periprocedure VAS was 3.2 versus 7.4 for Lidocaine and Placebo groups, respectively (p = 0.0001). Postprocedure VAS in the Lidocaine group was 4.1 ± 1.6 and that for the Placebo group was 6.1 ± 1.3 (P = 0.001). Mean daily dose of Nalbuphine in the Lidocaine group was 8 mg versus 18 for patients in the Placebo group (p = 0.002). Average length of post procedure hospital stay was 3.7 and 3.8 days for Lidocaine and Placebo groups, respectively (P = 0.36).ConclusionsIntra-arterial administration of buffered Lidocaine before infusing the embolization particle of TACE is safe and effective in dose as low as 50 mg for reducing peri and post-procedural pain and dosage of narcotic analgesics in patients with HCC.