Ojective To investigate the effect of neoadjuvant chemotherapy on the rocuronium muscle relaxation in breast cancer patients.
Methods Sixty female patients with breast cancer scheduled for radical mastectomy under general anesthesia in our hospital from July 2018 to February 2019 were selected, aged 29-60 years, BMI 18-29 kg/m2, falling into ASA physical status Ⅰ or Ⅱ. According to whether they had received neoadjuvant chemotherapy before surgery, they were divided into chemotherapy group (group C) and non-chemotherapy group (group NC), with 30 patients in each group. Patients in group C received 4 cycles of chemotherapy with adriamycin combined with taxol (AT) or adriamycin and cyclophosphamide combined with taxol (AC-T) treatment before surgical, while group NC received surgery directly without neoadjuvant chemotherapy. Preoperative electrolyte, liver and kidney function, HR, MAP and SpO2 at the time of entering the room, immediate time of intubation, and when T1% recovered to 10%, 25% and 75% of the two groups were recorded. Closed-loop muscle relaxant target control injection system was adopted for rocuronium dosing and monitoring muscle relaxant, T1% value was applied as a muscle relaxant monitor to measure the onset time of rocuronium bromide (time from rocuronium bromide injection end to T1% reduction until 0), 10% recovery time (time from rocuronium bromide injection end to T1% recovered 10%), recovery index (time ranges that T1% recovered from 25% to 75%). Intraoperative anesthetic drug dosage was recorded in both groups as well.
Results There was no statistically significant difference in electrolyte, liver and kidney function between two groups before operation. There was no statistically significant difference in HR, MAP and SpO2 at each time point during operation as well. Compared with the group NC, the onset time of rocuronium bromide in Group C was significantly longer (P < 0.05), and 10% recovery time was significantly shortened (P < 0.05). There was no statistically significant difference in recovery index between two groups. Compared with the group NC, the dosage of rocuronium in group C was significantly increased, and the average infusion rate was significantly increased (P < 0.05), while the dosage of propofol, remifentanil and dexmedetomidine showed no statistically significant difference.
Conclusion In patients undergoing radical breast cancer surgery after neoadjuvant chemotherapy, the onset time of rocuronium was significantly longer, 10% recovery time was significantly shorter, and the dosage of rocuronium increased significantly. |
