Objective To explore the effect of local anesthesia with lidocaine gel combined with guided imagery breathing relaxation intervention on intraoperative pain and anxiety in primary liver cancer patients treated with transcatheter arterial chemoembolization (TACE).

Methods Seventy primary liver cancer patients treated with TACE were selected, and randomly divided into the control group and intervention group, with 35 cases in each group. Two groups received external application of lidocaine gel combined with 2% lidocaine local infiltration anesthesia, and routine preoperative education. The intervention group received guided imagery combined with breathing relaxation training before 1 day of operation, refreshed the training in the morning on the operation day, and was simultaneously guided by nurses at four key time points during the operation. The Visual Analogue Scale (VAS) was used to evaluate the pain intensity at five intraoperative time pointsbaseline at admission (T0), at femoral artery puncture (T1), at chemotherapy drug perfusion (T2), at embolic agent injection (T3) and at extubation after the operation (T4), and the Zung Self-Rating Anxiety Scale (SAS) was used to evaluate the anxiety level at enrollment and before 30 minutes of operation, and the vital signs (heart rate, blood pressure and blood oxygen saturation), operation time, hospital stay, satisfaction and adverse reactions between two groups were compared.

Results In terms of VAS pain score, there was no statistically significant difference in the VAS scores at T0, T1 and T4 between two groups (P ＞ 0.05). At T2 and T3, the VAS scores of the intervention group were both lower than those of the control group (P ＜ 0.01). Regarding the SAS anxiety score, there was no statistically significant difference between two groups at the time of enrollment (P ＞ 0.05). Thirty minutes before the operation, the SAS score of the intervention group was lower than that of the control group (P ＜ 0.05). Moreover, the SAS score of the control group before 30 minutes of operation was higher than that at the time of enrollment (P ＜ 0.01), while that of the intervention group was lower than that at the time of enrollment (P ＜ 0.01). During T3 embolization, the heart rate and systolic blood pressure in the intervention group were lower than those in the control group (P ＜ 0.01), and the satisfaction score was higher than that in the control group (P ＜ 0.01). There was no statistically significant differences in the operation time, postoperative hospital stay and adverse reactions between two groups (P ＞ 0.05).

Conclusions The combination of lidocaine gel local anesthesia with guided imagery and respiratory relaxation intervention can effectively alleviate visceral pain and preoperative anxiety during the embolization period in liver cancer patients treated with TACE, educe sympathetic excitation responses, improve satisfaction, and does not prolong the surgical process. It is worthy of clinical promotion.