title: Electrochemotherapy under tumescent local anesthesia for the treatment of cutaneous metastases.
abstract: BACKGROUND
  The surgical management of cutaneous metastasis (CM) is challenging, particularly in elderly patients, in whom general anesthesia can be difficult because of comorbidity.
  
  
  OBJECTIVE
  To test the effectiveness of tumescent local anesthesia (TLA) to achieve adequate anesthesia during the treatment of extensive CM with electrochemotherapy (ECT), previously only performed under general anesthesia.
  
  
  METHODS
  We conducted five ECT treatments of CM with intralesional bleomycin under TLA. We examined pain scores before, during, and after treatment; analgesic use; and side effects. The intention of the treatment was palliative in all cases.
  
  
  RESULTS
  We treated four patients (ages 75-88) with CM with a mean area of 126 cm(2) (range 12-198 cm(2) ) with 356 mL of TLA per treatment (range 180-450 mL). The ECT treatment under TLA demonstrated that anesthesia was adequate, with moderate pain during and slight pain after the procedure as measured on a visual analog scale (VAS).
  
  
  CONCLUSIONS
  In this proof-of-principle study, we demonstrated that ECT can be performed under TLA; TLA might be a useful new anesthesia option for patients treated with ECT.
authors: Department of Dermatology, Venerology and Allergology, University of Leipzig, Leipzig, Germany. michael.kendler@medizin.uni-leipzig.de
authors: Michael
authors: M
authors: Kendler
authors: Martin
authors: M
authors: Micheluzzi
authors: Tino
authors: T
authors: Wetzig
authors: Jan C
authors: JC
authors: Simon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000379:methods*; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage*; D001761:Bleomycin / Q000008:administration & dosage*; D053672:Electrochemotherapy; D005260:Female; D006801:Humans; D016393:Lymphoma, B-Cell / Q000188:drug therapy / Q000473:pathology; D008297:Male; D010147:Pain Measurement; D010166:Palliative Care; D010865:Pilot Projects; D011446:Prospective Studies; D011788:Quality of Life; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000556:secondary*
chemical_list: D000903:Antibiotics, Antineoplastic; D001761:Bleomycin