Failure of neuromuscular blockade despite high doses of rocuronium and atracurium in a patient with colorectal carcinoma : A case report

Article Article scientifique Rapport de cas Failure of neuromuscular blockade despite high doses of rocuronium and atracurium in a patient with colorectal carcinoma : A case report eng 2024-10-07 2025-01-01 author Dos Santos Rocha André Alexandre 0000-0001-6038-8500 From the Division of Anaesthesiology, Department of Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine, University Hospitals of Geneva, Geneva, Switzerland (ADSR, MB, RS, GA, ES), Department of Anaesthesia, Northern Lisbon University Hospital Centre, Lisbon, Portugal (ADSR), University Clinic of Anesthesiology and Reanimation, Faculty of Medicine, University of Lisbon, Portugal (ADSR), Division of Clinical Pharmacology and Toxicology, Department of Anaesthesiology, Pharmacology and Intensive Care, University Hospitals of Geneva, Geneva, Switzerland (AN). 877181 author Betello Marco 402558 author Nikolaou Argyro 952167 Département d'anesthésiologie, pharmacologie et soins intensifs (APSIC) author Sudy Roberta 911679 Département d'anesthésiologie, pharmacologie et soins intensifs (APSIC) author Albu Gergely 0000-0002-7508-8567 705225 author Schiffer Eduardo 0000-0002-7415-4315 33705 Département d'anesthésiologie, pharmacologie et soins intensifs (APSIC) 73-76 10.1097/EJA.0000000000002076 39628417 0265-0215 PMC11620290 Resistance to the effects of rocuronium and other neuromuscular blocking agents (NMBA) has been previously reported, including delayed onset of relaxation, rapid recovery and incomplete paralysis under recommended doses. These conditions have been associated with denervation injury, burns, immobilisation, infections, metabolic disorders, and drug interactions. In this report, we describe the case of a young male without any known pre-disposing factor for NMBA resistance, who failed to attain muscle relaxation with non-depolarising NMBA despite high doses of rocuronium and atracurium during two surgeries for colorectal cancer, several months apart. Investigations for drug failure and genetic testing did not indicate a plausible cause. After chemotherapy and tumour resection, the patient underwent a third surgical procedure under general anaesthesia with normalised NMBA response. Patient's written consent was obtained for publication. Humans Rocuronium / administration & dosage Atracurium / administration & dosage Male Neuromuscular Blockade / methods Neuromuscular Blockade / adverse effects Neuromuscular Nondepolarizing Agents / administration & dosage Colorectal Neoplasms / surgery Adult Androstanols / administration & dosage Dewey 617 63 Département d'anesthésiologie, pharmacologie, soins intensifs et urgences 229 false 1280 Pharmaco-omiques et médecine de précision 1003 47 La médecine périopératoire et l'anesthésie 70 538 Groupe Savoldelli Georges (simulation) 878 European journal of anaesthesiology 42 1 a08754fa-188c-4018-b3a3-b78c0d8e68ad Article (Published version) Public Article_scientifique_from_europePmc.pdf 587487 application/pdf CC BY-NC-ND-4.0 6525469016f64dae2ccca69bfb04d6aff50cf992dceb5da0f6ae4728288621e4 openAccess Faculté de médecine / Section de médecine clinique / Département d'anesthésiologie, pharmacologie, soins intensifs et urgences

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Failure of neuromuscular blockade despite high doses of rocuronium and atracurium in a patient with colorectal carcinoma : A case report	European journal of anaesthesiology			2025	1	0

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Betello, Marco