Discussion on the application of different anesthesia methods in performing radiofrequency ablation for hepatocellular carcinoma / 介入放射学杂志

ABSTRACT

Objective To evaluate the safety and effectiveness of different anesthesia methods in performing percutaneous radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC). Methods The clinical data of 102 HCC patients, who were admitted to authors’ hospital during the period from January 2010 to October 2014 to receive percutaneous RFA, were retrospective analyzed. According to the anesthesia method used for RFA, the patients were divided into 3 groups. Group A control of breathing and general intravenous anesthesia; group B general intravenous anesthesia with spontaneous breathing; group C local anesthesia with monitoring. The vital signs, perioperative adverse reactions and procedure-related complications were analyzed. Results The operation time of group A and B was longer than that of group C (P<0.02); the time of waking up after the operation in group A was longer than that in group B (P<0.03). During the performance of RFA the patient’s vital signs in group A and B were more stable than those in group C (P<0.01);during the performance of RFA the blood oxygen saturation in patients of both group A and B remained above 95%(from the placement of oxygen masks to the end of operation), although the blood oxygen saturation of group B was lower than that of group A (P<0.05), and the blood oxygen saturation of group C was lower than that of both group A and B (P<0.01). The incidences of adverse reactions such as involuntary limb activity, tears, need of anesthesia machine-assisted respiration, etc. in group A were significantly lower than those in group B and C (P<0.01). The postoperative complications such as subcutaneous emphysema, pneumothorax or need of thoracic drainage in group B and C were significantly higher than those in group A (P<0.05). Conclusion General intravenous anesthesia can reduce the operation time of RFA for HCC, which can create a safe and comfortable surgical environment for patients. The use of general intravenous anesthesia together with the control of breathing is the safest method with lower incidence of perioperative adverse reactions and procedure-related complications; it might be a relatively optimal anesthesia method for RFA of HCC.