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Reduction of muscle contraction and pain in electroporation-based treatments:An overview

World Journal of Clinical Oncology 2021年第5期12卷 367-381页

作者： Roberta Fusco Elio Di Bernardo Valeria D'Alessio Simona Salati Matteo Cadossi Department of Medical Oncology IGEA SpACarpi 41012ModenaItaly

BACKGROUND In the first studies of electrochemotherapy(ECT),small cutaneous metastases were treated and only mild or moderate pain was observed;therefore,pain was not considered a significant *** the procedure began to be applied to larger cutaneous metastases,pain was reported more *** that reason,reduction of both muscle contractions and pain have been investigated over the *** To present an overview of different protocols described in literature that aim to reduce muscle contractions and pain caused by the electroporation(EP)effect in both ECT and irreversible EP *** Thirty-three studies published between January 1999 and November 2020 were *** protocol designs and electrode geometries that reduce patient pain and the number of muscle contractions and their intensity were *** The analysis showed that both high frequency and bipolar/biphasic pulses can be used to reduce pain and muscle contractions in patients who undergo EP ***,adequate electrode design can decrease EP-related ***,needle length,diameter and configuration of the distance between the needles can be optimised so that the muscle volume crossed by the current is reduced as much as ***/biphasic pulses with an inadequate pulse length seem to have a less evident effect on the membrane permeability compared with the standard pulse *** that reason,the number of pulses and the voltage amplitude,as well as the pulse duration and frequency,must be chosen so that the dose of delivered energy guarantees EP *** Pain reduction in EP-based treatments can be achieved by appropriately defining the protocol parameters and electrode *** results can be achieved with high frequency and/or bipolar/biphasic ***,the efficacy of these alternative protocols remains a crucial point to be assessed further.

关键词： Electrochemotherapy Irreversible electroporation Pain Muscle contraction Monopolar or monophasic pulses bipolar or biphasic pulses

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