Pain after Percutaneous Irreversible Electroporation of Renal Tumors Is Not Dependent on Tumor Location

Igor Sorokin, Aaron H. Lay, Nikitha K. Reddy, Noah Canvasser, Murthy Chamarthy, Jeffrey A. Cadeddu

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Introduction: Irreversible electroporation (IRE) is a non-thermal minimally invasive technique that is used to treat small renal masses (SRMs). Prior work has demonstrated greater narcotic requirements after radiofrequency ablation (RFA) for tumors that are closer to body-wall musculature. We hypothesized that pain after IRE is not dependent on tumor location due to the athermal mechanistic action. Materials and Methods: A retrospective review of 50 consecutive percutaneous IRE and RFA cases was performed from 2013 to 2014. Eight patients were excluded from analysis due to incomplete anesthesia record and/or multiple ablations per session, leaving 21 patients in each group. Data collected included patient age, sex, body mass index, nephrometry score, shortest distance to the closest body-wall muscle, perioperative narcotic use, and patient-reported pain score. Pearson correlation test and multivariable linear regression were used to identify predictors of postoperative pain, with significance set at p = 0.05. Results: There was no difference in the mean distance from tumor edge to the nearest body-wall muscle between IRE and RFA (2.6 cm vs 2.4 cm, p = 0.729, respectively). Total mean perioperative narcotic usage was 20.4 mg after IRE and 26.7 mg after RFA (p = 0.096). Mean postoperative pain score (scale 0-10) was slightly higher after RFA (4.3) compared with IRE (2.4), but this was not statistically significant (p = 0.088). Pearson correlation test identified tumor proximity to be significiantly associated with both pain score (p = 0.011) and postoperative narcotic use (p = 0.049) after RFA but not after IRE. On multivariable analysis, only tumor proximity to the body wall was significantly correlated to pain score (-1.4, p = 0.041) after RFA but was not found to be a factor for pain after IRE. Conclusions: Patients whose tumors lie close to their body-wall musculature do not have greater narcotic requirements or higher pain scores in the perioperative period after IRE. Percutaneous IRE may be preferred over RFA for SRMs that are close to the body wall to minimize pain.

Original languageEnglish (US)
Pages (from-to)751-755
Number of pages5
JournalJournal of Endourology
Volume31
Issue number8
DOIs
StatePublished - Aug 1 2017
Externally publishedYes

Fingerprint

Electroporation
Kidney
Pain
Narcotics
Neoplasms
Postoperative Pain
Muscles
Perioperative Period
Linear Models
Body Mass Index
Anesthesia

Keywords

  • IRE
  • irreversible electroporation
  • pain
  • radiofrequency ablation
  • renal mass
  • RFA

ASJC Scopus subject areas

  • Urology

Cite this

Pain after Percutaneous Irreversible Electroporation of Renal Tumors Is Not Dependent on Tumor Location. / Sorokin, Igor; Lay, Aaron H.; Reddy, Nikitha K.; Canvasser, Noah; Chamarthy, Murthy; Cadeddu, Jeffrey A.

In: Journal of Endourology, Vol. 31, No. 8, 01.08.2017, p. 751-755.

Research output: Contribution to journalArticle

Sorokin, Igor ; Lay, Aaron H. ; Reddy, Nikitha K. ; Canvasser, Noah ; Chamarthy, Murthy ; Cadeddu, Jeffrey A. / Pain after Percutaneous Irreversible Electroporation of Renal Tumors Is Not Dependent on Tumor Location. In: Journal of Endourology. 2017 ; Vol. 31, No. 8. pp. 751-755.
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AU - Sorokin, Igor

AU - Lay, Aaron H.

AU - Reddy, Nikitha K.

AU - Canvasser, Noah

AU - Chamarthy, Murthy

AU - Cadeddu, Jeffrey A.

PY - 2017/8/1

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N2 - Introduction: Irreversible electroporation (IRE) is a non-thermal minimally invasive technique that is used to treat small renal masses (SRMs). Prior work has demonstrated greater narcotic requirements after radiofrequency ablation (RFA) for tumors that are closer to body-wall musculature. We hypothesized that pain after IRE is not dependent on tumor location due to the athermal mechanistic action. Materials and Methods: A retrospective review of 50 consecutive percutaneous IRE and RFA cases was performed from 2013 to 2014. Eight patients were excluded from analysis due to incomplete anesthesia record and/or multiple ablations per session, leaving 21 patients in each group. Data collected included patient age, sex, body mass index, nephrometry score, shortest distance to the closest body-wall muscle, perioperative narcotic use, and patient-reported pain score. Pearson correlation test and multivariable linear regression were used to identify predictors of postoperative pain, with significance set at p = 0.05. Results: There was no difference in the mean distance from tumor edge to the nearest body-wall muscle between IRE and RFA (2.6 cm vs 2.4 cm, p = 0.729, respectively). Total mean perioperative narcotic usage was 20.4 mg after IRE and 26.7 mg after RFA (p = 0.096). Mean postoperative pain score (scale 0-10) was slightly higher after RFA (4.3) compared with IRE (2.4), but this was not statistically significant (p = 0.088). Pearson correlation test identified tumor proximity to be significiantly associated with both pain score (p = 0.011) and postoperative narcotic use (p = 0.049) after RFA but not after IRE. On multivariable analysis, only tumor proximity to the body wall was significantly correlated to pain score (-1.4, p = 0.041) after RFA but was not found to be a factor for pain after IRE. Conclusions: Patients whose tumors lie close to their body-wall musculature do not have greater narcotic requirements or higher pain scores in the perioperative period after IRE. Percutaneous IRE may be preferred over RFA for SRMs that are close to the body wall to minimize pain.

AB - Introduction: Irreversible electroporation (IRE) is a non-thermal minimally invasive technique that is used to treat small renal masses (SRMs). Prior work has demonstrated greater narcotic requirements after radiofrequency ablation (RFA) for tumors that are closer to body-wall musculature. We hypothesized that pain after IRE is not dependent on tumor location due to the athermal mechanistic action. Materials and Methods: A retrospective review of 50 consecutive percutaneous IRE and RFA cases was performed from 2013 to 2014. Eight patients were excluded from analysis due to incomplete anesthesia record and/or multiple ablations per session, leaving 21 patients in each group. Data collected included patient age, sex, body mass index, nephrometry score, shortest distance to the closest body-wall muscle, perioperative narcotic use, and patient-reported pain score. Pearson correlation test and multivariable linear regression were used to identify predictors of postoperative pain, with significance set at p = 0.05. Results: There was no difference in the mean distance from tumor edge to the nearest body-wall muscle between IRE and RFA (2.6 cm vs 2.4 cm, p = 0.729, respectively). Total mean perioperative narcotic usage was 20.4 mg after IRE and 26.7 mg after RFA (p = 0.096). Mean postoperative pain score (scale 0-10) was slightly higher after RFA (4.3) compared with IRE (2.4), but this was not statistically significant (p = 0.088). Pearson correlation test identified tumor proximity to be significiantly associated with both pain score (p = 0.011) and postoperative narcotic use (p = 0.049) after RFA but not after IRE. On multivariable analysis, only tumor proximity to the body wall was significantly correlated to pain score (-1.4, p = 0.041) after RFA but was not found to be a factor for pain after IRE. Conclusions: Patients whose tumors lie close to their body-wall musculature do not have greater narcotic requirements or higher pain scores in the perioperative period after IRE. Percutaneous IRE may be preferred over RFA for SRMs that are close to the body wall to minimize pain.

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