Effect of preoperative neoadjuvant chemotherapy on rocuronium bromide-induced neuromuscular blockade in patients undergoing radical resection of gastrointestinal tumors
10.3760/cma.j.cn131073-20240709-00810
- VernacularTitle:术前新辅助化疗对胃肠道肿瘤根治术患者罗库溴铵肌松效应的影响
- Author:
Panpan DUAN
1
;
Juanli ZHANG
;
Meng CUI
;
Yang LI
;
Jianhua CHANG
;
Rui YANG
Author Information
1. 西电集团医院麻醉科，西安 710021
- Publication Type:Journal Article
- Keywords:
Rocuronium;
Neoadjuvant chemotherapy;
Stomach neoplasms;
Intestinal neoplasms;
Neuromuscular blockade
- From:
Chinese Journal of Anesthesiology
2025;45(8):972-975
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effect of preoperative neoadjuvant chemotherapy on rocuronium bromide-induced neuromuscular blockade in patients undergoing radical resection of gastrointestinal tumors.Methods:In this retrospective cohort study, the medical records from patients pathologically diagnosed with gastrointestinal tumors (stageⅡ or Ⅲ) and underwent elective radical tumour resection under general anaesthesia, aged 43-74 yr, with a body mass index of 18-25 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ at Shaanxi Provincial People′s Hospital from November 2021 to November 2022, were collected. The patients were divided into 2 groups based on whether preoperative neoadjuvant chemotherapy was performed: non-chemotherapy group and chemotherapy group. Non-chemotherapy group did not receive neoadjuvant chemotherapy before surgery and underwent direct surgery without receiving neoadjuvant chemotherapy. Chemotherapy group received 4 weeks of chemotherapy with FOLFOX (5-fluorouracil, leucovorin, oxaliplatin), XELOX (capecitabine + oxaliplatin) or SOX (oxaliplatin + tegio) the three regimens before surgery. The neuromuscular monitoring was initiated after induction of intravenous anaesthesia, and rocuronium bromide 0.6 mg/kg was intravenously injected when the train-of-four ratio stabilized at 90%-110%. Mechanical ventilation was performed after endotracheal intubation when the train-of-four count was 0. When T 1 began to recover, rocuronium 0.2 mg/kg was intravenously injected, and rocuronium was intermittently injected during operation to maintain muscle relaxation. The onset time, complete muscle relaxation time, recovery index, 90% recovery index, maintenance time and consumption of rocuronium were recorded. Results:A total of 40 patients were finally included, with 20 in each group. Compared with non-chemotherapy group, the onset time was significantly prolonged, the recovery index, 90% recovery index and consumption of rocuronium were increased, the time for complete muscle relaxation was shortened ( P<0.05), and no significant change was found in the maintenance time of muscle relaxation in chemotherapy group ( P>0.05). Conclusions:Preoperative neoadjuvant chemotherapy can prolong the onset and recovery time of rocuronium, shorten the time to complete muscle relaxation and increase the consumption in patients undergoing radical resection of gastrointestinal tumors.
