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Background

The surgical management of cutaneous metastasis (CM) is challenging, particularly in elderly patients, in whom general anesthesia can be difficult because of comorbidity.

Objectives

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 cm2 (range 12–198 cm2) 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.