Scientific article
Case report
OA Policy
English

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

Published inEuropean journal of anaesthesiology, vol. 42, no. 1, p. 73-76
Publication date2025-01-01
First online date2024-10-07
Abstract

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.

Keywords
  • 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
Citation (ISO format)
DOS SANTOS ROCHA, André Alexandre et al. Failure of neuromuscular blockade despite high doses of rocuronium and atracurium in a patient with colorectal carcinoma : A case report. In: European journal of anaesthesiology, 2025, vol. 42, n° 1, p. 73–76. doi: 10.1097/EJA.0000000000002076
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Article (Published version)
Identifiers
Journal ISSN0265-0215
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