The Safety and Efficacy of Oxycodone Versus Fentanyl in Percutaneous Microwave Ablation of a Liver Tumour Abutting the Capsule

PurposeThe present study compared the safety and efficacy of oxycodone with those of fentanyl under non-intubated general anaesthesia in percutaneous microwave ablation (MWA) of a liver tumour abutting the capsule.Materials and MethodsThirty-eight patients underwent MWA of liver cancers abutting the capsule. Patients received 0.1mg/kg oxycodone (O group) or 1g/kg fentanyl (F group) prior to the start of ablation. Both groups received continuous infusions of propofol for non-intubated general anaesthesia during ablation. The primary outcomes were the pain scores (11-point numeric rating scale, NRS) within 24h after MWA. Vital signs, body movement during ablation, and opioid side effects after ablation were recorded. The need for additional analgesics was recorded 24h after MWA.ResultsThe pain NRS scores were lower in the O group than in the F group at 0.5 (P=0.035), 3 (P=0.002), and 6h (P=0.001) after MWA, and fewer patients required additional analgesics in the O group (6 of 20 vs. 13 of 18, P=0.022) within 24h. The average 24-h dose of dezocine was 5.54.1mg in the F group and 2.1 +/- 3.3mg in the O group (P=0.008). A significant reduction in the respiratory rate (P=0.020) and more body movements were observed in the F group (P=0.027) during ablation with non-intubated general anaesthesia. No differences in post-operative nausea and vomiting (PONV) were observed between the two groups, but dizziness occurred significantly more often in the O group (P=0.033). No significant differences in other vital signs were observed before, during, and after the procedure.Conclusions Oxycodone provides better analgesia and reduces post-operative opioid consumption without significant respiratory or hemodynamic instability.