Methods: Between May 2012 and December 2016, a total of 2,999 patients (1,067 males, 1,932 females; mean age 43 years; range 19 to 70 years) who underwent radiofrequency ablation, removal of varices, and perforating vein ligation under general anesthesia with a laryngeal mask airway or spinal anesthesia were retrospectively analyzed. Data including duration of hospitalization, postoperative Visual Analog Scale (VAS) pain scores, patient satisfaction, nausea, vomiting, sore throat, headache, back pain, and urinary retention were recorded using medical records.
Results: Of the patients, 2,512 received general anesthesia with laryngeal mask airway and 487 received spinal anesthesia. The mean duration of hospitalization was 10.7 h in the general anesthesia group and 22.5 h in the spinal anesthesia group, indicating a significant difference (p<0.001). At one hour postsurgery, the mean pain scores were significantly higher in the general anesthesia group than in the spinal anesthesia group (1.7±0.1 cm vs 0.1±0.1 cm) (p<0.001). In the general anesthesia group, the patient satisfaction rate was significantly higher than in the spinal anesthesia group (97% vs 92%) (p<0.001). The incidence of vomiting was higher in the general anesthesia group, whereas the incidence of nausea, headache, and urinary retention was higher in the spinal anesthesia group (p<0.001, for all).
Conclusion: During radiofrequency ablation, laryngeal mask airway facilitates earlier hospital discharge with improved patient satisfaction than spinal anesthesia, but at the expense of such adverse effects as vomiting and sore throat. Spinal anesthesia is associated with less postoperative pain than general anesthesia via LMA, although it may cause nausea, headache, and urinary retention.