Cardiovascular Effects of Muscle Relaxation During Laparoscopic Surgery (RELAX-LAP)

March 27, 2025 updated by: Martijn Boon, Leiden University Medical Center

The Impact of Neuromuscular Relaxation and Nociception Guided Anaesthesia on Hemodynamic Variables During Lower Abdominal Laparoscopic Surgery: a Strategy Trial.

Many surgical procedures are performed using the laparoscopic approach. However, insufflation of the abdomen (pneumoperitoneum) has detrimental hemodynamic effects. The investigators intend to investigate the effect of deep neuromuscular block and nociception guided anaesthesia on hemodynamic variables during pneumoperitoneum for lower abdominal laparoscopic surgery.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

34

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

  • Name: Martijn Boon, MD PhD
  • Phone Number: +31 71-5262301
  • Email: m.boon@lumc.nl

Study Locations

      • Leiden, Netherlands
        • Leiden University Medical Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

ASA 1-3;

  • Scheduled for lower laparoscopic abdominal surgery;
  • Ability to give oral and written consent;

Exclusion Criteria:

  • Known or suspected neuromuscular disorders impairing neuromuscular function;
  • Allergies to muscle relaxants, anesthetics or narcotics;
  • A (family) history of malignant hyperthermia;
  • Women who are or may be pregnant;
  • Preexisting cardiac disease (any);
  • Untreated or uncontrolled hypertension;
  • COPD gold 3 or higher
  • Preexistent esophageal pathology (stricture, tumor, diverticulum)
  • Any increased risk factor for upper gastro intestinal tract bleed:
  • History of GI surgery;
  • History of GI bleed;
  • Esophageal varices;
  • Gastric or esophageal inflammation;
  • Severe thrombocytopenia (less than 50k) or severely elevated INR (>4).

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
No Intervention: Standard Care
Experimental: Goal directed anesthesia
Deep neuromuscular blockade (post tetanic count 1-2 twitches) and nociception guided anaesthesia
Deep neuromuscular blockade (PTC 1-2) Nociception level index (NOL) target 10-25

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Blood pressure
Time Frame: 30 minutes after installation of pneumoperitoneum
Mean arterial pressure
30 minutes after installation of pneumoperitoneum

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Blood pressure
Time Frame: 5 minutes after installation of pneumoperitoneum
Mean arterial pressure
5 minutes after installation of pneumoperitoneum
Blood pressure
Time Frame: 60 minutes after installation of pneumoperitoneum
Mean arterial pressure
60 minutes after installation of pneumoperitoneum
Cardiac output
Time Frame: 5 minutes after installation of pneumoperitoneum
Cardiac output (l/min) as measured by non invasive arterial pulse contour anlysis
5 minutes after installation of pneumoperitoneum
Cardiac output
Time Frame: 30 minutes after installation of pneumoperitoneum
Cardiac output (l/min) as measured by non invasive arterial pulse contour anlysis
30 minutes after installation of pneumoperitoneum
Cardiac output
Time Frame: 60 minutes after installation of pneumoperitoneum
Cardiac output (l/min) as measured by non invasive arterial pulse contour anlysis
60 minutes after installation of pneumoperitoneum

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Ejection fraction
Time Frame: 5 minutes after installation of pneumoperitoneum
Left ventricular ejection fraction measured by TEE
5 minutes after installation of pneumoperitoneum
Ejection fraction
Time Frame: 30 minutes after installation of pneumoperitoneum
Left ventricular ejection fraction measured by TEE
30 minutes after installation of pneumoperitoneum
Ejection fraction
Time Frame: 60 minutes after installation of pneumoperitoneum
Left ventricular ejection fraction measured by TEE
60 minutes after installation of pneumoperitoneum

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

September 1, 2020

Primary Completion (Actual)

March 26, 2025

Study Completion (Actual)

March 27, 2025

Study Registration Dates

First Submitted

August 21, 2019

First Submitted That Met QC Criteria

August 30, 2019

First Posted (Actual)

September 3, 2019

Study Record Updates

Last Update Posted (Actual)

April 2, 2025

Last Update Submitted That Met QC Criteria

March 27, 2025

Last Verified

March 1, 2025

More Information

Terms related to this study

Other Study ID Numbers

  • P19.042

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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