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Ann Fr Anesth Reanim · Jan 1995
Case Reports[Prolonged neuromuscular block induced by mivacurium in a patient treated with cyclophosphamide].
- D Vigouroux and L Voltaire.
- Service d'Anesthésie Urgences et Réanimation, CHR Rangueil, Toulouse.
- Ann Fr Anesth Reanim. 1995 Jan 1; 14 (6): 508-10.
AbstractA case is reported of prolonged neuromuscular block after mivacurium chloride for laparoscopic cholecystectomy, in a 45 years old patient, treated with cyclophosphamide for a Wegener's granulomatosis. The neuromuscular function monitoring by train-of-four showed a duration of action of 75 min after an intubation dose of 0.20 mg.kg-1. Additional bolus of 1 mg, corresponding to 25% of usual doses, every 10 or 15 min, were sufficient for maintaining muscle relaxation. Spontaneous recovery, without any antagonization, lasted 40 min for a TOF ratio (T4/T1) > or = 70%. Recovery index from 25 to 75% were 13 min. Plasma butyrilcholinesterases activity were reduced to a level of 50%. With reference to literature about succinylcholine, the responsibility of cyclophosphamide is likely, and discussed. This observation shows the value of monitoring the neuromuscular transmission.
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