Published online May 24, 2021. doi: 10.5306/wjco.v12.i5.367
Peer-review started: December 24, 2020
First decision: March 17, 2021
Revised: March 17, 2021
Accepted: April 22, 2021
Article in press: April 22, 2021
Published online: May 24, 2021
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 issue. As the procedure began to be applied to larger cutaneous metastases, pain was reported more frequently. For that reason, reduction of both muscle contractions and pain have been investigated over the years.
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 treatments.
Thirty-three studies published between January 1999 and November 2020 were included. Different protocol designs and electrode geometries that reduce patient pain and the number of muscle contractions and their intensity were analysed.
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 treat
Pain reduction in EP-based treatments can be achieved by appropriately defining the protocol parameters and electrode design. Most results can be achieved with high frequency and/or bipolar/biphasic pulses. However, the efficacy of these alternative protocols remains a crucial point to be assessed further.
Core Tip: This is an overview of different published protocols that aim to reduce muscle contractions and pain due to the electroporation (EP) effect. The analysis showed that both high frequency and bipolar/biphasic pulses can be used to reduce pain and muscle contractions. Moreover, appropriate electrode design can lower EP-related morbidity.