Clinical observation of efficacy of brief mindfulness-based body scan in control of intraoperative hypertension and pain in patients undergoing radiofrequency ablation for liver cancer under local anesthesia
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1.Teaching and Research Section of Clinical Nursing, Xiangya Hospital, Central South University, Changsha 410008, China;2.Department of Liver Surgery, Xiangya Hospital, Central South University, Changsha 410008, China;3.Xiangya School of Nursing, Central South University, Changsha 410013, China

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R735.7

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    Abstract:

    Background and Aims During the radiofrequency ablation (RAF) treatment under local anesthesia for liver cancer, anxiety and stress are inevitable reactions in patients, which will make the patients more sensitive to pain, and thereby lead to increased blood pressure and decreased tolerance, even forced discontinuation of treatment. Therefore, maintaining the stability of vital signs and relieving pain are the guarantees of the successful implementation of RAF under local anesthesia for patients with liver cancer. Conventionally, antihypertensive and analgesic medications are often used to relieve the above symptoms in clinical practice. Still, these drugs possess inherent side effects and increase the patients' economic burden. Mindfulness-based stress reduction (MBSR) therapy has been proven to positively impact the control of various adverse emotions and chronic pain. However, its value in the treatment of liver cancer is rarely reported. Therefore, this study was conducted to investigate the efficacy of a brief mindfulness-based body scan (BMBS) in controlling intraoperative hypertension and pain in patients receiving RAF under local anesthesia for liver cancer and provide data support for its clinical application.Methods The data of 67 patients who underwent RAF for liver cancer from January 2018 to June 2019 in the Department of Liver Surgery, Xiangya Hospital, Central South University, were retrospectively analyzed. Of the patients, 32 cases received BMBS only without administering antihypertensive drugs throughout RAF (BMBS group), and the other 35 cases received sublingual administration of amlodipine sublingual amlodipine tablets to control the blood pressure and keep it around the normal level (control group). All patients underwent blood pressure measurement 4 times before and after RAF (10 min before the initiation of BMBS or oral administration of antihypertensive drugs, immediately before the initiation of BMBS or oral administration of antihypertensive medications, at the initiation of RAF, and the completion of RAF). The baseline characteristics and efficacy evaluation variables, such as changes in blood pressure, the frequency of analgesic drug use, and scores for pain assessment during the RAF process, were compared between the two groups.Results There were no significant differences in the baseline conditions between the two groups of patients (all P>0.05). The results of the intra-group comparison showed that the systolic and diastolic pressure were significantly reduced in both the BMBS group and control group after the complementary treatment (all P<0.05), The results of the inter-group comparison showed that there were no significant differences in both systolic pressure and diastolic pressure at each predefined time point between the two groups (all P>0.05). The number of analgesic requirements and pain scores was significantly lower in the BMBS group than that in the control group (P=0.044, P=0.003).Conclusion As a simple MBSR method, BMBS has a good control effect on intraoperative hypertension and pain in patients with liver cancer undergoing RAF under local anesthesia and has a reasonable prospect of clinical application. Since its implementation depends on professional training of medical staff in psychological intervention, it is necessary to strengthen the training in this aspect in the future so that it can provide benefits to more patients.

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PENG Jing, XIAO Liang, QU Yingjun, LI Lan, LIU Xin, XIE Yanhui. Clinical observation of efficacy of brief mindfulness-based body scan in control of intraoperative hypertension and pain in patients undergoing radiofrequency ablation for liver cancer under local anesthesia[J]. Chin J Gen Surg,2023,32(2):254-260.
DOI:10.7659/j. issn.1005-6947.2023.02.011

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History
  • Received:April 04,2022
  • Revised:July 26,2022
  • Adopted:
  • Online: March 02,2023
  • Published: