Objective To analyze the affecting factors of equivalent doses of fentanyl and sufentanil on liver function in patients with liver cancer after radiofrequency ablation.
Methods A retrospective analysis was performed on 211 patients with liver cancer (single tumor ≤ 3 cm) who underwent radiofrequency ablation from January 1, 2016 to December 31, 2019, including 166 males and 45 females, with Child-Pugh grade A. Patients were divided into two groups according to the drugs used during the operation: fentanyl group (n = 92) and sufentanil group (n = 119). Clinical data such as gender, age, BMI, tumor size, operation time, smoking and drinking history, underlying diseases (hypertension, diabetes), and liver function indexes such as ALT, AST, TBiL, ALP, LDH, ALB, and GGT, and analgesia were recorded. Use of hepatoprotective drugs (diammonium glycyrrhizinate) were also recorded. Logistic regression was used to screen independent influencing factors of ALT > 3 × ULN 1 day after surgery in HCC radiofrequency patients.
Results Compared with the 1 day preoperative, ALT, AST, TBiL and LDH of the two groups were significantly increased 1 day after surgery, and ALT and AST 7 days after surgery were significantly increased (P < 0.05). Compared with 1 day after surgery, the ALT, AST, TBiL and LDH of the two groups were significantly decreased 7 days after operation (P < 0.05). Compared with the fentanyl group, ALT and AST in the sufentanil group were significantly decreased on the first postoperative day (P < 0.05). Hierarchical Logistic regression showed that, age < 65 (OR = 0.301, 95% CI 0.149-0.610, P = 0.001), tumor size 1.1-2.0 cm (OR = 0.417, 95% CI 0.191-0.910, P = 0.028), operation time 10-20 minutes (OR = 0.231, 95% CI 0.081-0.658, P = 0.006) were protective factors for ALT > 3 × ULN 1 day after surgery in sufentanil group.
Conclusion For patients with early-stage liver cancer undergoing radiofrequency ablation, the liver protection effect of sufentanil was better than that of fentanyl, and sufentanil was a protective factor for ALT > 3 × ULN on the first postoperative day. |
