Hilar Nerve Block Regional Anesthesia in Patients Undergoing Liver Thermal Ablation

Introduction: We describe our single-center initial experience of use of a hepatic hilar nerve block in the context of hepatic thermal ablation procedures. Patient pain relief scores, intra- and postprocedural analgesic use, as well as procedural details are presented.

Method(s): Prospective data collected between April 2022 and October 2022. Seven patients (mean age 62.8) underwent hepatic hilar nerve block prior to liver tumor thermal ablation, compared with a control group of seven patients (mean age 60.3) who underwent liver tumor thermal ablation without nerve block. Tumor sizes between the two groups were comparable (14 vs. 13 mm). Visual pain scores, analgesia and sedation requirements, and complications were collated.

Result(s): Patients who received a hilar nerve block had a lower visual pain score than the control group (2.4 compared with 4.5) and decreased opioid and sedation requirement (mean fentanyl dose 134 vs. 210 µg; mean midazolam dose 1.7 vs. 2.4 mg). There were no complications related to the hilar nerve block.

Conclusion(s): A hepatic hilar nerve block offers safe and effective regional anesthetic for patients undergoing hepatic ablation, with potential for decreasing patient pain and analgesia/sedative requirements.

Publication History

Article published online:
09 February 2023