General Anesthetic Precaution in Irreversible Electroporation

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Pattharaporn Sombood
Warunee Buayam
Phongthara Vichitvejpaisal
Sasikorn Feinggumloon


Irreversible Electroporation or Nanoknife is an innovative insertion of needles through the skin for tumor ablation. Consequently, the high electric field creates nanapores in the cell membrane resulting cell death without triggering an inflammatory process, hence bodily immunological response can eradicate it without a trace. Therefore, a Nanoknife is a safe technique in preservation of vital and scaffolding structures within the treatment zone such as gall bladder, pancreas, ureter, blood vessel or nerve fibers. In addition, it reduces susceptibility to heat sink effects which is implicated as a possible contributing cause of the residual tissue and recurrent tumor. However, this procedure can result in full body muscle spasm, severe muscle contraction and cardiac dysrhythmias. As a result, anesthesia personnel have to be aware of the sequence of events. Typically, they provide general anesthesia with endotracheal intubation and muscle relaxation as well as monitor patients’ vital signs particularly an electrocardiography throughout the process. Additionally, a defibrillator must be readily available in case of emergency cardiac arrythmia and arrest.

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Review articles


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