Research Progress on Perioperative Pain Management in Hepatic Arterial Chemoembolization

Abstract

Transarterial chemoembolization (TACE) is an important treatment for unresectable intermediate to advanced hepatocellular carcinoma, but it is often accompanied postoperatively by postembolization syndrome, with pain as the core symptom, severely affecting patients' quality of life and treatment compliance. This article systematically reviews the research progress on perioperative pain associated with TACE, covering pain characteristics and classification, pathophysiological mechanisms, assessment tools, and management strategies. Pain mainly presents as upper right abdominal distension or dull pain within hours to 48 hours after the procedure and is closely related to tissue ischemia, necrosis, and the release of inflammatory mediators. Pain assessment commonly uses the visual analog scale (VAS) and numeric rating scale (NRS), emphasizing dynamic and multi-timepoint evaluation. Current pain management focuses on multimodal analgesia, combining nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, and adjuvant analgesics, while gradually integrating non-pharmacological interventions such as acupuncture, psychotherapy, and rehabilitation training. Multidisciplinary team collaboration plays a key role in optimizing pain management. Future efforts should focus on conducting high-quality research to promote personalized, preventive, and integrated pain management, improving the overall treatment experience and rehabilitation quality for TACE patients.