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ANESTHETIC PHARMACOLOGY

Cisatracurium Pharmacodynamics in Patients with Oculopharyngeal Muscular Dystrophy

Marie-Josée Caron, MD^*, François Girard, MD, FRCPC^*, Dominique C. Girard, MD, FRCPC^*, Daniel Boudreault, MD, FRCPC^*, Bernard Brais, MD, MPhil, PhD, Edgard Nassif, MD, FRCSC, Philippe Chouinard, MD, FRCPC^*, Monique Ruel, RN, CCRP^*, and André Duranceau, MD, FRCSC

Departments of *Anesthesiology, Medicine, and Surgery, Centre Hospitalier de l’Université de Montreal, Hôpital Notre-Dame, Montréal, Quebec, Canada

Address correspondence and reprint requests to François Girard, MD, FRCPC, Department of Anesthesiology, CHUM, Hôpital Notre-Dame, 1560 Sherbrooke E., Montreal, Quebec, Canada, H2L 4M1. Address e-mail to francois.girard.chum{at}ssss.gouv.qc.ca.

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.