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Taxane modulation of anesthetic sensitivity in surgery for nonmetastatic breast cancer

Regina E Linganna1, Warren J Levy1, Ivan J Dmochowski2

  • 1University of Pennsylvania, Department of Anesthesiology.

Journal of Clinical Anesthesia
|June 4, 2015
PubMed
Abstract

Insights

Patients receiving taxanes before surgery showed increased blood pressure response to incision, suggesting taxanes may alter general anesthetic effects by affecting microtubule stability.

Area of Science:

  • Anesthesiology
  • Oncology
  • Cell Biology

Background:

  • The mechanism of general anesthesia is not fully understood.
  • Microtubule stability is a potential target for anesthetic action.
  • Taxanes, chemotherapy drugs, alter microtubule stability.

Purpose of the Study:

  • To investigate if taxane exposure influences patient response to general anesthetics.
  • To test the hypothesis that taxane-induced changes in microtubule stability confer partial resistance to general anesthetics.
  • To compare anesthetic requirements in breast cancer patients receiving taxanes before versus after surgery.

Main Methods:

  • Retrospective analysis of anesthetic records from adult women with nonmetastatic breast cancer.
  • Measurement of hemodynamic responses (heart rate, blood pressure) to surgical incision.
  • Quantification of inhaled anesthetic agents, induction agents, and rescue medications administered.

Main Results:

  • The neoadjuvant taxane group (pre-surgery) exhibited a significantly higher increase in blood pressure upon incision compared to the control group (P = .03).
  • No significant difference in heart rate response was observed between groups (P = .53).
  • The neoadjuvant group received more morphine (26.3 vs 15.5 mg, P = .02) but not higher concentrations of inhaled anesthetics (P = .15).

Conclusions:

  • Alteration of microtubule stability by taxanes may contribute to modulating the effects of general anesthetics.
  • This suggests microtubule dynamics are one of several mechanisms involved in inhaled anesthetic action.
  • Further research is warranted to elucidate the role of microtubule stability in general anesthesia.
Keywords:
General anestheticMechanismSurgeryTaxane

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