Int J Stomatol

Inter J Stomatol ›› 2009, Vol. 36 ›› Issue (3): 253-255，259.doi: 10.3969/j.issn.1673-5749.2009.03.001

• Original Articles •     Next Articles

Anesthesia management for radioactive seed implantation in treatment of oral and

YANG Xu-dong1, DONG Wen1, ZHANG Jian-guo2   

  1. 1. Dept. of Anesthesiology, School of Stomatology, Peking University, Beijing 100
  • Received:2008-10-30 Revised:2009-01-19 Online:2009-05-20 Published:2009-05-20
  • Contact: YANG Xu-dong

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Abstract: Objective To investigate characteristics of anesthesia management for radioactive seed implantation in treatment of oral and maxillofacial malignant tumor. Methods 76 patients with oral and maxillofacial malignant tumor receiving treatment of radioactive seed implantation were given three types of anesthesia according to indications: Local anesthesia plus intravenous sedation（group LA）, general anesthesia with endotracheal intubation（group TT） and general anesthesia with laryngeal mask airway（group LMA）. Changes of patients′ blood pressure（BP）, heart rate（HR） and saturation of pulse oxygen（SpO2） during operation were recorded. Characteristics of anesthesia
induction and maintenance and perioperative complications were observed. Results Among the 76 patients, 12 patients were enrolled into group LA, 24 patients were enrolled into group TT and 40 patients were enrolled into
group LMA. Perioperative cardiovascular response in group LA was more intense than that in group TT and group LMA（P<0.05）. The lowest SpO2 during operation of group LA was lower than preoperative value and than that of group TT and group LMA（P<0.05）. Patients in group LA had more body movements and more pain than that in group TT and group LMA（P<0.05）. One patient of group LA had hypoxemia during operation. In group TT, 9
patients had difficult intubation and the successful rate of first insertion was 62.5%. One patient of group TT received emergency tracheotomy because of postoperative airway obstruction. The successful rate of first insertion in
group LMA was 90%. There was no difference between group TT and group LMA with respect to cardiovascular change and lowest SpO2. 9 patients of group LMA showed leakage during operation but no hypoxemia occurred.
Conclusion In maxillofacial radioactive seed implantation surgery, different anesthesia methods should be chosen according to indications. Local anesthesia plus intravenous sedation is not likely to produce perfect analgesia, while general anesthesia with endotracheal intubation may
have difficult intubation. Laryngeal airway mask is easy to insert and can be used under safety and feasibility in such operations.

Key words: anesthesia, maxillofacial, malignant tumor, radioactive seed


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