Purpose: To evaluate the impact of prophylactic use of dexamethasone and scopolamine on analgesic and antiemetic agent requirements after transarterial chemoembolization. Materials and Methods: A total of 148 patients underwent 316 rounds of chemoembolization for hepatocellular carcinoma at a single institution over a 17-month period. Patient charts were retrospectively reviewed for demographic data, procedural technique, and use of analgesic and antiemetic medications. Patients were grouped into three categories: group A received steroid prophylaxis before and after the procedure, group B received steroid prophylaxis before the procedure only, and group C received no steroid prophylaxis. Results: Analysis was performed on 125 patients undergoing 252 procedures. Demographics were similar among groups. Overall, 86 (68.8%) were male, and mean age was 62 years (range, 39-82 y). Ninety-one patients (75%) had Child-Pugh class A cirrhosis and 25% had Child-Pugh class B cirrhosis. Dexamethasone was not significantly associated with decreased analgesic agent use (P =.6). Group A patients used significantly fewer antiemetic agents (Δ = 0.89; P =.007) compared with group C. A transdermal scopolamine patch was not associated with reduced use of antiemetic agents (P =.3). Age was inversely associated with analgesic (P <.001) and antiemetic agent use (P =.004). Men received significantly fewer antiemetic agents than women (P =.002), whereas there was no significant difference in analgesic agent use (P =.7). Conclusions: The use of steroids did not affect analgesic agent use and had a minor effect on antiemetic requirements. The use of a scopolamine patch was not associated with reduced antiemetic agent use.
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