Neuromuscular blockade characteristics of cisatracurium in patients receiving chemotherapy: A preliminary study in breast cancer patients

Review of the Interactions Between Anesthetic Agents and Chemotherapeutic Agents in Cancer Cell Lines Studied In Vitro

Cancer remains the second leading cause of death worldwide, second to cardiovascular diseases. A significant number of patients with cancer require surgical interventions, highlighting the need to understand the interactions between popular agents used in general anesthesia and in chemotherapy, to provide safe anesthesia and effective anticancer treatment. Given that, for many clinicians, interactions between these 2 broad groups of drugs are not well known; therefore, this topic requires special attention. We have prepared this overview by presenting the actual findings in this field in order to introduce clinicians to this issue. The article considers commonly used drug groups in anesthesiology, such as intravenous and inhaled anesthetics, benzodiazepines, muscle relaxants, and opioids. Their interactions with commonly used antineoplastic drugs, described so far in the literature, are presented. These occurrences highlight the necessity of careful monitoring and control during perioperative care, to not interfere with chemotherapy targets and to prevent the severity of pharmacological adverse effects. To introduce these complex mechanisms, we prepared this article based on the most recent publications possible, considering the many studies carried out in vitro and in vivo, as well as clinical trials. This review was prepared on the basis of 73 articles published from 1989 to 2024, as well as on the authors' knowledge and clinical experience. This article aims to review the interaction between anesthetics and chemotherapeutic agents, based on clinical studies and studies conducted on in vitro cancer cell lines and in vivo animal models.

The Use of Muscle Relaxants After Chemotherapy and Radiotherapy

Introduction

Patients after chemotherapy and radiotherapy while being operated can suffer from different systemic problems, which may complicate the anesthetic management. Some interactions between muscle relaxants and chemotherapeutics can occur.

Aim

This article aims to present the use of muscle relaxants in cancer patients who have undergone chemotherapy and radiotherapy.

Material and Methods

Our work is based on the available literature and the authors' experience.

Conclusion

Based on our observations and a thorough examination of the medical literature, it is advisable to exercise significant caution when employing muscle relaxants in individuals undergoing chemotherapy and radiotherapy. All muscle relaxants can behave differently after chemotherapy and radiotherapy, and for this reason, practitioners should familiarize themselves with the pharmacodynamics and pharmacokinetics of their chosen muscle relaxant.