关键词: 多功能喉罩, 气管插管, 经皮射频消融术, 日间手术

Abstract: Background and purpose: Percutaneous radiofrequency ablation (PRFA) for the treatment of small hepatocellular carcinoma (HCC) has been widely accepted and used in the ambulatory surgeries. With the development of enhanced recovery after surgery (ERAS), it is becoming more and more important to choose an appropriate method of anesthesia. This study aimed to compare the safety of the multi-function intubating laryngeal mask (multi-function ILM) with tracheal intubation in PRFA of ambulatory surgeries under general anesthesia. Methods: One hundred and forty patients scheduled for PRFA of ambulatory surgery for HCC under general anesthesia were randomized into two groups with 70 cases respectively: multi-function ILM (A) group and tracheal intubation (B) group. The data ［systoLnc blood pressure (SBP), diastoLnc blood pressure (DBP), heart rate (HR), P_mean, P_peak and P_ETCO₂］ of the patients in the two groups were recorded and compared at different time points: before anesthesia induction (T₀), before intubation or multi-function ILM insertion (T₁), immediately after (T₂) and 5 min after (T₃), 10 min after (T₄), 15 min after (T₅) intubation or multi-function ILM insertion, extubation or multi-function ILM removal (T₆). Meanwhile we observed the bucking, regurgitation and aspiration, dysphoria, increased airway secretions, hypoxemia after extubation, postoperative sore throat. The awakening time and patients’ satisfaction scores were recorded. Results: The SBP, DBP and HR of patients at the moment of multi-function ILM insertion/intubation (T₂) in group A were significantly lower with smaller fluctuation compared with group B (P<0.05). The awakening time of patients in group A was significantly shorter than that of those in group B (P<0.05). The incidences of compLncations such as increased airway secretions and postoperative sore throat in group A were significantly less compared with group B (P<0.05). There was no statistically significant difference in the effect of machine ventilation, the incidence of intraoperative compLncation and the medical economic benefit between the two groups at different time points. Conclusion: The appLncation of multi-function ILM in the PRFA of ambulatory surgeries for HCC has good effect of ventilation, less postoperative compLncations, and proved to be safer and more reliable. In addition, it has less impact on hemodynamics of patients and patients’ blood pressure would be more stable. The awakening time will also be shorter than that of patients with tracheal intubation. Therefore, the appLncation of multi-function ILM has advantages in the PRFA of ambulatory surgeries over tracheal intubation under general anesthesia as it can shorten the awakening time, improve patient satisfaction and reduce the time of treatment.

Key words: Multi-function ILM, Tracheal intubation, Percutaneous radiofrequency ablation, Ambulatory surgery