In a recent symposium on radiofrequency ablation of liver cancer, a liver transplant specialist once said to me, “Some liver cancer patients who had received radiofrequency ablation treatment were found to have cancer tissue remaining in the liver cancer lesions after radiofrequency ablation after liver transplantation”. The implication was to question the efficacy of radiofrequency ablation in treating liver cancer. After thinking for a moment, I asked the specialist, “Where did you do the RF ablation in these cases you mentioned, and do you know the anesthesia method when performing the RF ablation treatment?” . He said, “Basically, they are patients from their own hospital, and the physicians in their hospital use local anesthesia when performing radiofrequency ablation of liver tumors. I told this specialist, “Unless the diameter of very early liver cancer is below 3 cm and still within the liver parenchyma, local anesthesia can be applied when doing radiofrequency ablation. For a larger hepatocellular carcinoma lesion, it usually takes 1 hour or even longer to complete a radiofrequency ablation of the tumor for the purpose of cure. If only local anesthesia is applied, the patient will have obvious pain during the operation, which makes it difficult to cooperate well with the operation, and the patient’s moaning or shouting will make the doctor lack the mood to complete the intended surgical plan with ease, and it is reasonable that the residual cancer lesion will occur.” The above story illustrates a common misunderstanding in radiofrequency ablation treatment for liver tumors. In order to simplify the process of radiofrequency ablation treatment for liver tumors, many physicians apply local anesthesia when performing this treatment. In order to simplify the process of liver tumor RF ablation, many physicians apply local anesthesia to perform this treatment. Unbeknownst to them, local anesthesia is not able to anesthetize the ablation focal area, and during the ablation process, the local temperature of the ablation focal area can reach 105°C. Such temperature will definitely produce pain, which in turn will make patients fearful, irritable and resistant to the treatment, and under such circumstances, physicians have to hastily withdraw from the treatment plan. In fact, general anesthesia is very necessary for radiofrequency ablation treatment of liver tumors, especially for radiofrequency ablation treatment with the purpose of curing tumors. General anesthesia can make the patient completely painless, under which the treatment time will seem ample, the physician will have a relaxed mood to focus on the implementation of the treatment plan, and the patient will get a good treatment effect. In addition, during general anesthesia, since the physician can easily control the patient’s breathing, this will also allow for more precise puncture and needle placement of the tumor, reducing the number of ineffective punctures and making it easier to ensure safety and efficacy.