Natriuretic Peptide Concentrations of B-type (BNP) During Anesthesia in Patients Previously Sensitized to Anthracyclines

Not Applicable

Completed

Brief Summary: The cardiotoxicity of anthracyclines chemotherapy remains a major problem, despite clinical and echocardiographic monitoring. In the case of treatment for breast cancer, surgery requiring general anesthesia may follow chemotherapy. Although a possible interaction between general anesthetics and anthracyclines on systolic function is only rarely mentioned, some cases of heart failure and / or conduction disturbances peranesthésique were observed in patients treated or previously treated with anthracyclines. The determination of concentration of BNP is a diagnostic tool used in the detection of heart failure and acute coronary syndromes. The question of a possible synergism between cardiotoxic anthracyclines and anesthetic agents arises. Given its minimally invasive nature and its diagnostic value, the BNP assay might thus allow to highlight a possible subclinical deficiency. To our knowledge, there is very little data regarding a possible synergism between cardiotoxic anthracyclines and anesthetic agents.

Detailed Description: The cardiotoxicity of anthracyclines chemotherapy remains a major problem, despite clinical and echocardiographic monitoring. In the case of treatment for breast cancer, surgery requiring general anesthesia may follow chemotherapy. Although a possible interaction between general anesthetics and anthracyclines on systolic function is only rarely mentioned, some cases of heart failure and / or conduction disturbances peranesthésique were observed in patients treated or previously treated with anthracyclines. The determination of concentration of BNP is a diagnostic tool used in the detection of heart failure and acute coronary syndromes. In fact, it is one of the most sensitive markers of impaired myocardial function, and an increase in interest rates may precede any other biological changes. In a patient who received anthracycline, although it remains asymptomatic elevation of NT-proBNP concentration may persist for some months after exposure, and that, whatever the doses received. The question of a possible synergism between cardiotoxic anthracyclines and anesthetic agents arises. Given its minimally invasive nature and its diagnostic value, the BNP assay might thus allow to highlight a possible subclinical deficiency. To our knowledge, there is very little data regarding a possible synergism between cardiotoxic anthracyclines and anesthetic agents.

Recruitment & Eligibility

Inclusion Criteria

Women over 18 years with effective contraceptive method (if applicable)
NT-proBNP <125 pg / ml
ASA 1 or 2,
Breast cancer histologically proven
Mastectomy or lumpectomy
Neoadjuvant chemotherapy with anthracyclines in 6 months or received no chemotherapy with anthracyclines,
Patients who received the briefing and signed the informed consent
Patients affiliated to a social security system.

Exclusion Criteria

Patients for whom the maintenance of general anesthesia does not use halogenated.
Renal impairment: Creatinine clearance <60 ml / min,
Patients who for reasons psychological, social, family or geographical could not be treated or monitored regularly according to the criteria of the study, patients deprived of liberty or under guardianship.
Presence of a cardiopathy
Pregnant Women

Arm && Interventions

Group	Intervention	Description
Peptide Natriurétique de type B	Peptide Natriurétique de type B	Peptide Natriurétique de type B

Primary Outcome Measures

Name	Time	Method
Pre-operative Concentration of NT-proBNP	Before breast surgery	Mean concentration of NT-proBNP measured before surgery.
Concentration of NT-proBNP at the End of Intervention	At the end of breast surgery	Mean concentration of NT-proBNP measured at the end of intervention
Post-operative Concentration of NT-proBNP	24 hours after breast surgery	Mean concentration of NT-proBNP measured 24 hours after breast surgery