Propofol-Based Deep Sedation for Percutaneous Radiofrequency Ablation in Sick Elderly Patients with Hepatocellular Carcinoma in a Developing Country

The aim of this study was to evaluate and compare the clinical efficacy of propofol-based deep sedation (PBDS) for percutaneous radiofrequency ablation (RFA) in sick (American Society of Anesthesiologists [ASA] physical status III-IV) and nonsick (ASA physical status I-II) elderly patients in a teaching hospital in Thailand.We undertook a retrospective review of the sedation service records of elderly patients who underwent RFA procedures from 2010 to 2012.Patients were classified into two groups according to ASA physical status.In group A, patients had ASA I-II, while in group B, patients had ASA III-IV.Primary outcome variable was the successful completion of procedure.Secondary outcome variables were sedation-related complications during and immediately after procedure.There were 113 elderly patients who underwent RFA procedures by using PBDS during the study period.Of these, 69 patients were in group A and 44 patients were in group B. There were no significant differences in age, weight, duration of sedation, and mean dose of propofol, fentanyl, and midazolam between the two groups.All procedures in both groups were successfully completed.Overall and cardiorespiratory-related complications in both groups were not significantly different.All sedation-related complications were easily treated, with no adverse sequelae.PBDS for percutaneous RFA in sick elderly patients by trained anesthetic personnel with appropriate monitoring was safe and effective.The clinical efficacy of this technique in sick elderly patients was not different or worse than in nonsick elderly patients.Serious complications were rare.