Radiologist-guided Analgosedation with Ketamine/Midazolam: A Feasible Strategy to Expand Percutaneous Tumor Ablation Capacity.
Anne Bettina Beeskow, Manuel Florian Struck, Aboelyazid Elkilany et al.
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In 30 seconds
This retrospective, single-centre study assessed radiologist-guided analgosedation with midazolam and S-ketamine for percutaneous microwave or radiofrequency ablation of liver, kidney, and bone tumours. It included 140 procedures in 115 patients treated between January 2022 and July 2024. Of 115 planned patients, 113 (98.3%) completed treatment as intended; no major complications were reported. After the service transitioned from general anaesthesia, procedural volume rose from 2.1 to 6.3 ablations per month (p < 0.05), while mean in-room time was 42 ± 34 min vs. 98 ± 42 min (p < 0.05).
Key findings
- Of 115 planned patients, 113 (98.3%) completed ablation as intended.
- No major complications occurred; one minor hepatic hematoma and transient vomiting in four patients (3.5%) were reported.
- Monthly procedural volume increased from 2.1 to 6.3 ablations after transition to analgosedation (p < 0.05).
- Mean in-room time was 42 ± 34 min under analgosedation vs. 98 ± 42 min under general anesthesia (p < 0.05).
Why it matters
The findings suggest that, in this centre, radiologist-guided analgosedation was compatible with high completion rates and few reported complications while procedural volume increased and in-room time decreased. This may be relevant where anaesthesia resources constrain access to percutaneous ablation, although the results describe one centre’s experience and do not establish comparative effectiveness.
What to keep in mind
The study was retrospective and single-centre; the abstract does not report a randomised comparison with general anaesthesia.