Anesthetic management for radiofrequency ablation in patients with hepatocellular carcinoma in a developing country

Authors : Amornyotin S, Jirachaipitak S, Wangnatip S

DOI :

Volume : 3

Issue : 1

Year : 2015

Page No : 00086

Radiofrequency ablation (RFA) is a novel minimally invasive technique of tumor destruction by heat in hepatic malignancies. It is one of the most common interventional medical procedures performed throughout the world. The study is aimed to report and evaluate the choices and techniques, drugs used and complications of anesthesia for percutaneous RFA in patients with hepatocellular carcinoma during the period of January, 2010 to December, 2012 in Siriraj Hospital in Thailand. The patients’ characteristics, pre-anesthetic problems, anesthetic techniques, drugs, duration of anesthesia, and anesthesia-related complications were assessed and summarized by using descriptive statistics. During the study period there were 400 RFA procedures. Mean age 63.0±11.4 years. The majority of them was male (69.0%) and classified in ASA physical status II (68.3%). Most common pre-anesthetic problems were liver disease (57.5%), hypertension (46.8%), hematologic disease (37.3%) and diabetes mellitus (35.3%). Intravenous sedation (99.3%) was the main anesthetic technique. The mainly used anesthetic agents were propofol, fentanyl and midazolam. The duration of anesthesia ranged from 15 to 270 minutes. The overall anesthesia-related complication rate was 23.8%. Hypotension (16.5%) was the most frequent anesthetic complication. Almost all of the RFA procedures, intravenous sedation technique can be used effectively. However, clinical signs should be carefully observed and the anesthetic personnel had to optimize the patient’s condition for safety and beware of complications.