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首页> 外文期刊>Abdominal radiology. >Pain in percutaneous liver core-needle biopsy: a randomized trial comparing the intercostal and subcostal approaches
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Pain in percutaneous liver core-needle biopsy: a randomized trial comparing the intercostal and subcostal approaches

机译：经皮肝芯针活检的疼痛：随机试验比较肋间和潜伏方法

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Purpose: Effective pain control during and after percutaneous core needle liver biopsy is important with regard to ethical considerations and patient comfort. In this randomized double-blind study, we compared post-biopsy pain in the patients undergoing liver core-needle biopsy using either subcostal or intercostal approaches. Methods: All patients referred for ultrasound-guided CNLB between July 2017 and January 2018 to our interventional radiology department were randomized into two groups. Biopsy was performed through intercostal approach in the first group and through subcostal approach in the second group. The intensity of pain 0, 2, and 4 h after the procedure was compared in two groups using a 100-mm visual analogue scale. All biopsies were performed without procedural IV sedation. If patients' discomfort demanded administration of IV analgesics during or after the procedure, then the patients were excluded from the study. Results: In patients without routine procedural IV sedation, there was no significant difference in the pain level between the intercostal and subcostal groups immediately after the procedure (p = 0.055), but we found a significant difference in the pain level between the two groups 2 (7.5 mm, p = 0.001) and 4 (2 mm, p = 0.001) h after the procedure. Conclusion: The minimum amount of change in the VAS score that is considered clinically important is 13 mm on a 100-mm scale. Pain differences at 2 and 4 h in the two groups in this study were statistically but not clinically significant. Therefore, the authors suggest the use of subcostal route for ultrasound-guided liver biopsy whenever possible, but the results do not warrant the routine use of post-procedure analgesics in whom biopsy is performed via intercostal route.
机译：目的：经皮核心针肝活动期间和后的有效疼痛控制对于道德考虑和患者的舒适性很重要。在这种随机双盲研究中，我们使用亚挡板或肋间接近进行肝脏核心针活检的患者的活检疼痛。方法：2017年7月至2018年1月至2018年1月至2018年1月至2018年1月推荐的所有患者随机分为两组。通过第一组中的肋间方法和第二组的亚骨抑制方法进行活组织检查。使用100mm的视觉模拟量表在两组比较后，疼痛0,2和4小时的强度。所有活组织检查均在没有程序IV镇静的情况下进行。如果患者在程序期间或之后要求患者的镇痛药施用，那么患者被排除在研究之外。结果：在没有常规程序IV镇静的患者中，在程序后立即在肋间和亚骨囊组之间的疼痛水平没有显着差异（P = 0.055），但我们发现两组疼痛水平的显着差异（7.5mm，p = 0.001）和4（2mm，P = 0.001）H后的步骤。结论：在临床上的临床评分的最小变化量为100毫米级别为13毫米。这项研究中两组的2和4小时疼痛差异在统计学上但没有临床显着性。因此，作者建议在尽可能随时使用亚稳态途径进行超声引导肝活检，但结果不保证通过肋间路线进行活检的过程后镇痛药的常规使用。

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