• J Clin Anesth · Feb 2017

    Chemotherapy alters cisatracurium induced neuromuscular blockade characteristics: A prospective cohort study.

    • Amir Poya Zanjani, Maziar Maghsoudloo, Jalil Makarem, Fahimeh Farokhnia, Morteza Fazli, and Zahid Hussain Khan.
    • Tehran University of Medical Sciences, Assistant Professor, Dept. of Anesthesia and Intensive Care, Imam Khomeini Hospital Complex, Keshavarz Blvd., Tehran, 1419733141, Iran. Electronic address: p_zanjani@yahoo.com.
    • J Clin Anesth. 2017 Feb 1; 36: 84-87.

    Study ObjectiveTo 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.DesignThis is a non-randomized prospective cohort study.SettingOperating room of a university-affiliated teaching hospital.PatientsOut 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.InterventionAfter induction of anesthesia with thiopental and cisatracurium, neuromuscular monitoring was started for all patients.MeasurementsInitially 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 ResultsTime 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.ConclusionThis 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.Copyright © 2016 Elsevier Inc. All rights reserved.

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