title: Cisatracurium pharmacodynamics in patients with oculopharyngeal muscular dystrophy.
abstract: The pharmacodynamics of muscle relaxants in patients with oculopharyngeal muscular dystrophy (OPMD) have never been studied. We designed this study to compare the pharmacodynamics of cisatracurium in OPMD patients versus a control group. Forty patients were enrolled: 20 OPMD patients requiring general anesthesia for cricopharyngeal myotomy and 20 age-matched controls undergoing an operation of similar duration and expected blood loss. Anesthesia was standardized, and both groups received a bolus of cisatracurium 0.1 mg/kg. Onset time, time to 10% T1 recovery, and the intervals 10%-25% and 25%-75% were calculated for both groups. A subgroup analysis was performed in patients with a more severe form of OPMD. Demographic and intraoperative data were similar. Onset time was significantly longer in OPMD patients compared with the control group (4.6 +/- 1.5 min versus 3.4 +/- 1.0 min; P = 0.001). There was no difference in recovery times or indices between groups, regardless of the severity of the disease. In conclusion, there was no difference in the duration of a cisatracurium-induced neuromuscular block between OPMD patients and a control group. A delayed onset of action of the drug may occur.
authors.affiliation: Departments of *Anesthesiology, †Medicine, and ‡Surgery, Centre Hospitalier de l'Université de Montreal, Hôpital Notre-Dame, Montréal, Quebec, Canada.
authors.forename: Marie-Josée
authors.initials: MJ
authors.lastname: Caron
authors.forename: François
authors.initials: F
authors.lastname: Girard
authors.forename: Dominique C
authors.initials: DC
authors.lastname: Girard
authors.forename: Daniel
authors.initials: D
authors.lastname: Boudreault
authors.forename: Bernard
authors.initials: B
authors.lastname: Brais
authors.forename: Edgard
authors.initials: E
authors.lastname: Nassif
authors.forename: Philippe
authors.initials: P
authors.lastname: Chouinard
authors.forename: Monique
authors.initials: M
authors.lastname: Ruel
authors.forename: André
authors.initials: A
authors.lastname: Duranceau
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General; D001279:Atracurium; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D039141:Muscular Dystrophy, Oculopharyngeal / Q000503:physiopathology*; D003473:Neuromuscular Nondepolarizing Agents; D009435:Synaptic Transmission / Q000502:physiology
chemical_list: D003473:Neuromuscular Nondepolarizing Agents; D001279:Atracurium