Enhanced Recovery After Surgery-Based Multimodal Preemptive Analgesia for Perioperative Management in Transarterial Chemoembolization of Intermediate-to-Advanced Hepatocellular Carcinoma

To evaluate the effectiveness of the combination of hydrochloride hydromorphone and flurbiprofen ester for post-TACE intravenous patient-controlled intravenous analgesia (PCIA).

Sex

All

Minimum age

18 Years

Maximum age

80 Years

Inclusion Criteria:

1. Pathologically or clinically diagnosed with hepatocellular carcinoma according to the "Guidelines for Diagnosis and Treatment of Primary Liver Cancer" issued by the National Health Commission of China in 2024;
2. staged as China Liver Cancer Stage II-III1 or 2022 Barcelona Clinic Liver Cancer stage B-C14;
3. liver function classified as Child-Pugh grade A or B;
4. ECOG PS score 0-215;
5. meeting the following hematological criteria: white blood cell count ≥3×10⁹/L, platelet count ≥50×10⁹/L, hemoglobin ≥80 g/L, serum alanine aminotransferase (ALT), aspartate aminotransferase (AST) ≤twice the upper limit of normal (ULN), serum creatinine ≤1.5×ULN, INR \<1.5 or prothrombin time \<ULN + 4 s, albumin (ALB) ≥30 g/L, total bilirubin \<34 mmol/L.

Exclusion Criteria:

1. History of iodine contrast allergy;
2. severe psychological or psychiatric disorders;
3. history of long-term analgesic medication use;
4. severe cardiopulmonary disease;
5. severe uncontrolled infection;
6. incomplete medical records.

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• RESULTThompson AR, Vernamonti JP, Rollins P, Speck KE. Implementing Change: Sustaining Enhanced Recovery After Surgery Protocols in Pediatric Surgery Using Iterative Assessments. J Surg Res. 2024 Jun;298:371-378. doi: 10.1016/j.jss.2024.03.039. Epub 2024 Apr 25. PMID 38669783
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