Mediation of transcatheter arterial chemoembolization induced gastric slow-wave dysrhythmia by endogenous prostaglandin

BACKGROUND AND AIMS: In recent years, gastric slow-wave dysrhythmias induced by transcatheter arterial chemoembolization (TACE) have been observed. Enhanced endogenous prostaglandin may be a possible mechanism for the myoelectrical changes. The aim of this study was to evaluate whether the gastric slow-wave dysrhythmias induced by TACE may be mediated by ketoprofen, a prostaglandin synthesis inhibitor. METHODS: Twenty-three patients with hepatocellular carcinoma (HCC) admitted for TACE were enrolled. A follow-up TACE was scheduled to take place 2 months later. During the next admission for TACE, 50 mg of ketoprofen was given intramuscularly 12 h for 3 days, beginning 48 h before TACE, as premedication. Cutaneous electrogastrography (EGG) was performed before and within 24 h after TACE. RESULTS: The results showed that the change in the fasting EGG parameters after TACE without premedication was not statistically significant. However, the postprandial EGG parameters, including the dominant frequency (DF); the percentages of DF in the normal, bradygastric and tachygastric range; along with the dominant frequency instability coefficient, deteriorated significantly after the procedure (P < 0.01). After the follow-up TACE with ketoprofen premedication, neither the fasting nor postprandial EGG parameters in the control group changed significantly. CONCLUSIONS: Gastric slow-wave dysrhythmias induced by TACE may be mediated by ketoprofen, a prostaglandin synthesis inhibitor, in HCC patients. However, the improvement in the gastric myoelectrical activity does not eliminate the degree of nausea/vomiting after TACE.