Second Affiliated Hospital Zhejiang University School of Medicine
Overview
- Phase
- Not Applicable
- Intervention
- sevoflurane anesthesia
- Conditions
- Chemotherapeutic Toxicity
- Sponsor
- Second Affiliated Hospital, School of Medicine, Zhejiang University
- Enrollment
- 80
- Locations
- 2
- Primary Endpoint
- Muscle relaxation recovery index
- Last Updated
- 4 years ago
Overview
Brief Summary
Chemotherapy causes motor nerve dysfunction and degeneration that may alter the response to neuromuscular blocking drugs. To analyse the risk of residual neuromuscular block (RNMB) induced by rocuronium given in standard doses to patients who undergo chemotherapy within three months.
Detailed Description
Rocuronium, as a non depolarizing muscle relaxant with medium time effect, takes effect rapidly. It is an ideal neuromuscular blocker to replace succinylcholine for induction of tracheal intubation and maintenance of muscle relaxant under general anesthesia. Sevoflurane is widely used in clinic because of its low blood gas partition coefficient, rapid and stable induction and recovery, easy adjustment of anesthesia depth and strong controllability. In addition, the number of patients receiving preoperative adjuvant chemotherapy for malignant tumors is increasing year by year in China. The commonly used chemotherapy drugs, such as paclitaxel, platinum, vinorelbine, etc., have dose-dependent peripheral neurotoxicity. Therefore, to explore and study the influence of pathophysiological changes of patients receiving chemotherapy on the neuromuscular relaxation effect of sevoflurane combined with non depolarizing neuromuscular blockers, It is very important for anesthesia, resuscitation and perioperative management of chemotherapy patients. The purpose of this study is to reveal the effect of sevoflurane on rocuronium neuromuscular blockade in chemotherapy patients by comparing the difference of rocuronium neuromuscular blockade effect of sevoflurane and total intravenous anesthesia in chemotherapy patients and non chemotherapy patients, and to provide information for more safe and rational application of rocuronium in clinical anesthesia of chemotherapy patients.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Patients classified as American Society of Anesthesiology physical status (ASA PS) classes I, II or III
- •Aged between 18 and 70 years
- •Scheduled for radiofrequency ablation of liver tumours under general anaesthesia with an expected surgery duration shorter than 60min
Exclusion Criteria
- •Allergy to rocuronium
- •Myasthenia gravis
- •Guillain-Barre ́ syndrome
- •Duchenne muscular dystrophy or similar
- •Receiving drugs that might interfere with the neuromuscular transmission or the response to neuromuscular blockers, such as some anticonvulsants and antibiotics
Arms & Interventions
nonchemotherapy patients using sevoflurane anesthesia
Following induction of anesthesia and laryngeal mask placement, anesthesia will be maintained by inhalation of sevoflurane (approximately 1.3 × minimum alveolar concentration) and IV fentanyl according to clinical need.
Intervention: sevoflurane anesthesia
chemotherapy patients using sevoflurane anesthesia
Following induction of anesthesia and laryngeal mask placement, anesthesia will be maintained by inhalation of sevoflurane (approximately 1.3 × minimum alveolar concentration) and IV fentanyl according to clinical need.
Intervention: sevoflurane anesthesia
chemotherapy patients using total intravenous anesthesia
Following induction of anesthesia and laryngeal mask placement, maintenance of anesthesia will consist of target-controlled infusion of propofol at a plasma target concentration of 1.5-3.0µg/ml and IV fentanyl according to clinical need.
Intervention: Propofol Injection
nonchemotherapy patient using total intravenous anesthesia
Following induction of anesthesia and laryngeal mask placement, maintenance of anesthesia will consist of target-controlled infusion of propofol at a plasma target concentration of 1.5-3.0µg/ml and IV fentanyl according to clinical need.
Intervention: Propofol Injection
Outcomes
Primary Outcomes
Muscle relaxation recovery index
Time Frame: The first 90 min following intravenous injection of rocuronium
Time interval from 25% recovery to 75% recovery of the first twitch in the TOF stimulation pattern
Secondary Outcomes
- Onset time of muscle relaxation(The first 90 min following intravenous injection of rocuronium)