Incidence of sedation-related adverse events durine microwave ablation of liver cancer under deep sedation and analysis of its risk factors / 介入放射学杂志

ABSTRACT

Objective To analyze the the incidence of sedation-related adverse events occurring during percutaneous microwave ablation(PMWA)under deep sedation,and to identify the risk factors for hypoxemia,hypertension and body movement response.Methods The clinical data of 506 patients with liver cancer,who received PMWA under deep sedation at the First Affiliated Hospital of Nanjing Medical University of China between December 2018 and December 2022,were retrospectively analyzed.The sedation-related adverse events including hypoxemia,hypertension and body movement response were recorded.Univariate analysis and multivariate logistic regression analysis were used to assess the risk factors for hypoxemia,hypertension and body movement response.Results After excluding 20 patients whose clinical data were incomplete,the final study sample consisted of 486 patients.After deep sedation,hypotension occurred in 5 patients(1％),and the incidences of hypoxemia,hypertension and body movement response were 13.8％,13.2％and 25.5％respectively.No patient required urgent endotracheal intubation and no cardiovascular complications occurred.The body movement response did not increase the complications of PMWA.Multivariate analysis revealed that age ≥65 years(OR=1.034,P=0.033),BMI＞30 kg/m2(OR=1.865,P=0.039),and Child-Pugh grade B/C(OR=1.113,P=0.046)were the risk factors for hypoxemia.The ablation zone contacting the parietal peritoneum(OR=2.536,P＜0.01),ablation zone contacting the diaphragm(OR=1.795,P=0.001),and ablation zone contacting the adrenal gland(OR=1.581,P＜0.01)were the risk factors for hypertension.The ablation zone contacted the parietal peritoneum(OR=2.831,P＜0.01)and ablation zone contacted the diaphragm(OR=2.213,P=0.026)were the risk factors for body movement response.Conclusion For the treatment of liver cancer,PMWA under deep sedation is clinically safe and effective.The age ≥ 65 years,BMI＞30kg/m2,and Child-Pugh grade B/C are the risk factors for hypoxemia.The ablation zone contacting the parietal peritoneum,the diaphragm or the adrenal gland are the risk factors for hypertension.The ablation zone contacting the parietal peritoneum or the diaphragm are the risk factors for body movement response.(J Intervent Radiol,2023,32:1202-1206)