Reduced Periprocedural Analgesia After Replacement of Water for Injection with Glucose 5% Solution as the Infusion Medium for 90Y-Resin Microspheres

J Nucl Med. 2016 Nov;57(11):1679-1684. doi: 10.2967/jnumed.115.170779. Epub 2016 Jun 3.

Abstract

The primary aim of our study was to compare the need for periinterventional on-demand analgesia when water for injection (WFI) was replaced with glucose 5% (G5) for 90Y-resin microsphere administration.

Methods: Forty-one patients who received 77 radioembolization procedures with G5 (2014-2015) were retrospectively matched with 41 patients (77 radioembolization procedures) who received radioembolization with WFI (2011-2014) at our center. The need for on-demand pain medication was chosen as an objective and accessible measure of periprocedural pain experienced by patients.

Results: Patients were well matched according to sex, age, tumor type and involvement, and prior antiangiogenic therapies. Periinterventional analgesic requirements were significantly lower for radioembolization procedures performed with G5 than WFI: 5 of 77 (6.5%) versus 29 of 77 (37.7%), P ≤ 0,001, respectively. Early stasis (defined as slowed antegrade flow, before total vascular stasis) occurred in 12 of 154 (7.8%) radioembolization procedures overall and was not different (P ≤ 0.229) between the 2 groups (4/77 [5.2%] vs. 8/77 [10.4%]).

Conclusion: Slow pulsatile administration of 90Y-resin microspheres with WFI is associated with a low rate of stasis. Replacement of WFI with G5 significantly reduces the need for periprocedural analgesia. These data favor the use G5 for 90Y-resin microsphere implantation in daily practice.

Keywords: glucose 5% (G5); peri-procedural analgesia; radioembolization (RE); stasis rate; water for injection (WFI).

MeSH terms

  • Aged
  • Analgesics / administration & dosage*
  • Embolization, Therapeutic / adverse effects
  • Embolization, Therapeutic / methods
  • Glucose / administration & dosage*
  • Glucose / chemistry
  • Humans
  • Infusions, Intravenous / adverse effects
  • Injections / adverse effects
  • Microspheres*
  • Pain / etiology
  • Pain / prevention & control*
  • Pharmaceutical Vehicles / administration & dosage
  • Pharmaceutical Vehicles / chemistry
  • Radiopharmaceuticals / administration & dosage
  • Radiopharmaceuticals / adverse effects
  • Radiopharmaceuticals / chemistry
  • Retrospective Studies
  • Water / administration & dosage*
  • Water / chemistry
  • Yttrium Radioisotopes / administration & dosage*
  • Yttrium Radioisotopes / chemistry

Substances

  • Analgesics
  • Pharmaceutical Vehicles
  • Radiopharmaceuticals
  • Yttrium Radioisotopes
  • Water
  • Glucose