Hepatic chemoembolization: Effect of intraarterial lidocaine on pain and postprocedure recovery

Purpose: To determine if intraarterial lidocaine reduces pain during and af ter chemoembolization, and whether it influences postprocedure recovery. Methods: Two patient cohorts undergoing selective hepatic chemoembolization were compared. Chemoembolization was performed without lidocaine (control group) in 27 patients and intraarterial lidocaine was used (lidocaine group ) in 29 similar patients. Objective changes in patient manage ment were ass essed. Pain reduction in 31 more procedures with lidocaine (total 60) was a ssessed and related to tumor type. Results: During chemoembolization, intraarterial lidocaine reduced the need for additional intravenous analgesics from 69% to 19%. After chemoemboliza tion the mean Dilaudid dose in the first 24 hr was reduced from 9.5 mg to 4 .15 mg; accordingly, the mean length of hospital stay was reduced from 67.5 to 53.5 hr. During the day of chemoembolization, the mean oral fluid intak e increased from 420 ml (control group) to 487 ml (lidocaine group); the pe rcentage of patients taking solid food on the day of chemoembolization incr eased from 3% to 43%. Conclusion: Intraarterial lidocaine during chemoembolization reduces the se verity and duration of pain after chemoembolization resulting in faster rec overy thus reducing the length of hospitalization.