The Factors of Pain and Pain Management after Transarterial Chemoembolization in Patients with Hepatocellular Carcinoma

Abstract

Purpose: The purpose of this study was to identify the factors of pain and pain management after transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). Methods: Participants were 99 inpatients with HCC who underwent TACE at C University in Seoul from May to October 2016. The instruments used in this study were the Numerical Rating Scale (NRS), the Pain Management Index (PMI), and the modified Patient Outcome Questionnaire (American Pain Society). The data were analyzed using SPSS 24.0, specifically descriptive statistics, t-test, ANOVA, and multiple regression. Results: The percentage of patients who experienced pain after TACE was 66.7%. The mean pain score immediately after TACE was 4.43±2.36 and the highest score on average was 6.58±2.32. The pain score was highest at 5.24±5.67 hours after TACE. Significant factors influencing pain after TACE were the extent of embolization and the ECOG (Eastern Cooperative Oncology Group) score, which explained 26% of the variance in pain. PMI scores revealed that 33.3% of the participants were inadequately treated for pain. Conclusion: In order to properly manage pain after TACE, medical staff need accurate understanding of pain and to administer the appropriate dosage of analgesics. The development of pain management protocol for patients who have undergone TACE would help achieve these goals.