Effect Of Neoadjuvant Chemotherapy On Neuromuscular Block Of Cisatracurium In Patients With Gastric Cancer

Objective: To investigate the effect of neoadjuvant chemotherapy on neuromuscular block of cisatracurium in patients with gastric cancer.Methods: A total of 60 patients with American Society of Anesthesiologists physical status 1-3, undergoing selective laparoscopyassisted radical gastrectomy for gastric cancer,aged 18-79 yr,were divided into2 groups. Group A: non-chemotherapy group（n=30）, Group B: neoadjuvant chemotherapy group（n=30）. Anesthesia was induced with cisatracurium 0.15mg·kg^-1. Neuromuscular block was assessed by a muscle relaxation monitor（HXD-I C028） in response to train-of-four stimulation（TOF, 2Hz, 12s） of ulnar nerve. The onset of cisatracurium, duration of action,time of T₁ recovery to10% of baseline were recorded. When T₁ returned to 10% of baseline,cisatracurium was infused continuously at a initial rate of 1.5μg·kg^-1·min^-1 to maintain T₁ at 5%-10% of baseline by adjusting the infusion rate. The cisatracurium consumption in every thirty minutes was recorded and the average infusion rate in ninety minutes was calculated. Fifteen minutes before the end of surgery, the infusion of cisatracurium was terminated. Recovery index and time of TOFR recovery to 90% of baseline were recorded.Results: The onset of cisatracurium is prolonged in Group B compared with Group A with significantly statistical difference（P<0.05）. Duration of action of first dose of cisatracurium was 1921.00±263.78 s in Group A, and1485.20±205.60 s in Group B respectively with statistically significant difference（P<0.05）. Time of T₁ recovery to 10% was 2300.01±325.30 s in Group A, and 1816.25±337.19 s in Group B（P<0.05）. Recovery index and timeof TOFR recovery to 90% of baseline of cisatracurium is prolonged in Group B compared with Broup A（P<0.05）.The first thirty-minute consumption of cisatracurium was 2.87±0.57 mg in Group A, and 3.53±0.58 mg in Group B; the second was 2.59±0.46 mg,3.11±0.43 mg, and the third was 2.31±0.68 mg, 2.69±0.54mg（P<0.05） respectively. The average infusion rate in ninety minutes was 1.44± 0.23μg·kg^-1·min^-1in Group A, and 1.73±0.20μg·kg^-1·min^-1 in Group B（P<0.05）.Conclusion: The onset of cisatracurium is prolonged in patients who accept neoadjuvant chemotherapy. The duration of action of cisatracurium were shortened in patients who accept neoadjuvant chemotherapy. The average rate of cisatracurium infusion should be increased in patients who accept neoadjuvant chemotherapy. The consumption of cisatracurium is larger in patients who accept neoadjuvant chemotherapy. The recovery index time of cisatracurium is prolonged in patients who accept neoadjuvant chemotherapy.