Hypertension and tachycardia induced by irreversible electroporation in pancreatic cancer: An analysis based on clinical data.

Background: Irreversible electroporation (IRE) is a novel non-thermal ablation technology for unresectable tumors. Hypertension and tachycardia usually occur during the IRE. To date, there has been little explanation about this phenomenon.

Aim: To investigate the reasons of hypertension and tachycardia and appropriate preventive measures.

Methods: IRE was performed under general anesthesia and neuromuscular blockade. Systolic blood pressures, diastolic blood pressures, heart rate, and the distance of the electrode from abdominal aorta and adrenal gland during IRE were recorded.

Results: All of 78 patients underwent 96 IRE sessions, 44 (56.4%) patients occurred hypertension when the electrode was close to the abdominal aorta (< 2.0 cm). The median systolic blood pressures and diastolic blood pressures was 194 and 108 mmHg. Furthermore, 11 (14.1%) patients occurred tachycardia when the electrode was close to the adrenal gland (< 1.3 cm). The median heart rate of patients with tachycardia was 114 beats per minute. Furthermore, hypertension and tachycardia can be prevented with nicardipine and esmolol before treatment.

Conclusion: Intraoperative hypertension and tachycardia occur because electrodes close to the abdominal aorta (< 2.0 cm) and adrenal glands (< 1.3 cm), which can be prevented by preoperative treatment of vasoactive drugs.