Comparison of methods of anesthesia used during radio-frequency ablation of renal tumors in patients with high operative risk
Article published in Urologia Polska 2006/59/3.

authors

Elżbieta Kołodziejczyk ¹, Marcin Matuszewski ², Kazimierz Krajka ²

¹ Zakład Anestezjologii i Intensywnej Terapii, Samodzielny Publiczny Szpital Kliniczny, Akademickie Centrum Kliniczne Akademii Medycznej w Gdańsku
² Katedra i Klinika Urologii Akademii Medycznej w Gdańsku

keywords

kidney, renal cell carcinoma, radio-frequency ablation, anaesthesia

summary

Introduction. Authors in their article present preliminary experience with different methods methods of anaesthesia used for radio-frequency ablation treatment of renal cell carcinoma. The treatment is based on destruction of cancer cells with heat energy created around needle electrode introduced into the tumor under ultrasound or CT control.

Material and method. The group of 17 patients was evaluated. in patients with renal tumores. Four methods of anaesthesia were utilized: local, deep sedoanalgesia, general and subarachnoidal.

Comparing these methods, authors monitored circulatory system (HR, BP), respiratory function (puls-oxymetry), time of the procedure, pain, patient's comfort and security and especially possibility to conduct such therapy in patient with high operative risk, when potential hazard of general anaesthesia is higher than risk of the surgery. Patients were qualified into ASA groups according to their general health condition. Pain was evaluated by VAS scale during surgery (in local and subarachnoidal anaesthesia) and 30 minutes after in all groups. In years 2003-2005 this treatment was implemented in 17 patients, 56 to 79 years old, qualified for ASA 3 and 4 groups.

Results. Despite of the kind of anaesthesia termoablation procedures were done in planned scheme. The shortest time of treatment was achieved with local anaesthesia but it was bound with the worst pain score. In sedoanalgesia group time of the procedure was 62 min. VAS ranged 3 to 5, in general anasthesia group the time was 89 minutes and the pain score was 3-4. In subarachnoidal anaesthesia group the time was 83 minutes and the pain score during and after procedure was 0-1.

Conclusions. In authors opinion basing on the collected data the best method of anaesthesia was subarachnoidal, especially in patients with high operative risks. It also creates the best condition to perform the operation for the urologist.

references

correspondence