Zanjani AP, Maghsoudloo M, Makarem J, Farokhnia F, Fazli M, Khan ZH. Chemotherapy alters cisatracurium induced neuromuscular blockade characteristics: A prospective cohort study.
J Clin Anesth 2017;
36:84-87. [PMID:
28183581 DOI:
10.1016/j.jclinane.2016.10.025]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 09/20/2016] [Accepted: 10/27/2016] [Indexed: 11/15/2022]
Abstract
STUDY OBJECTIVE
To compare the characteristics of NMDR induced muscle paralysis in breast cancer patients with and without a history of recent chemotherapy with cyclophosphamide, doxorubicin and 5-fluorouracil (CAF) regimen.
DESIGN
This is a non-randomized prospective cohort study.
SETTING
Operating room of a university-affiliated teaching hospital.
PATIENTS
Out of a total of 50 patients who had undergone mastectomy, 22 patients were allocated to the "Chemo group" and 28 patients to the "Non-Chemo group", based on a valid history of recent chemotherapy.
INTERVENTION
After induction of anesthesia with thiopental and cisatracurium, neuromuscular monitoring was started for all patients.
MEASUREMENTS
Initially the time to 100% single-twitch (ST) suppression was measured. Then, the time for the appearance of the first response to post-tetanic count (PTC) stimulation, Train-of-Four (TOF) stimulation, and TOF50% were measured consequently.
MAIN RESULTS
Time to get STzero was significantly longer in the Chemo group than in the Non-chemo group. Time for the appearance of the first response of PTC and TOF and TOF50% was significantly shorter in the Chemo group than the other group. The mean duration of intense block was 27.66 minutes in the Chemo group versus 42.47 minutes in the Non-chemo group.
CONCLUSION
This research demonstrated that in patients having undergone chemotherapy, the effect of NDMRs starts with a longer lag time and finishes earlier too. Thus, these patients are ready for intubation after a longer time. Moreover, we have to repeat cisatracurium injections after shorter intervals to maintain the desired level of blockade.
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