Pain sensation and neuromuscular stimulation during argon plasma coagulation in gastrointestinal endoscopy

Abstract

According to the findings, APC may be associated with minor complications such as pain sensation and NMS. These complications were rarely seen, but occurred more often with pulsed APC than with forced or precise APC. Physicians should be aware of these complications.

Effectiveness and Safety of PRECISE APC for the Treatment of Bleeding Gastrointestinal Angiodysplasia - a Retrospective Evaluation

“…Due to its better depth control we assume a higher safety, especially in preventing perforations in lesions located in the cecum or small intestine. While we had no major or microperforations in our study, confirming the results with PRECISE APC in the treatment of angiodysplasias of a previous study [27], the reported perforation rate of APC after treating angiodysplasias is between 0.5 % and 1 %, predominantly in the cecum and small bowel.…”

“…Treatment-related complications were divided into major complication including perforation, Hb-relevant bleeding (post-interventional drop of 2 g/dL plus transfusion) and systemic infection. Complications like submucosal emphysema, fever, neuromuscular stimulation/neural sensation [27] and abdominal pain without perforation were defined as minor complications. Follow-up endoscopy and/or treatments were performed on demand only if the patient had a symptomatic re-bleeding or in case of a complication.…”

Second‐generation argon plasma coagulation: Two‐center experience with 600 patients

“…Depending on the degree, this effect may be painful in case of inadequate analgosedation of the patient. Eickhoff et al 17 . reported a 9.2% rate of NMS events in patients treated with APC 2 during a total of 152 procedures.…”

“…A further, but minor complication of APC is the so‐called neuromuscular stimulation (NMS), 7,11,17 which is a muscular contraction reflexively triggered by electrical stimulation of the nerves innervating the muscle. Depending on the degree, this effect may be painful in case of inadequate analgosedation of the patient.…”

“…APC has been reported to be safe and effective in treating such residual lesions 20 . Up to now, experience with APC 2 in treating adenoma remnants is limited 17 …”