Neuromuscular Blockade Comparison for GI-2 Recovery After Bowel Resection
Sugammadex VS Neostigmine and Glycopyrrolate Reversal of Neuromuscular Relaxation For Time to Return of Bowel Function After Bowel Resection: Prospective, Randomized, Triple-blinded Clinical Trial For Quality Improvement
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Contact
Study Contact
- Name: Robert R Field, MD
- Phone Number: 714-506-5703
- Email: fieldr@hs.uci.edu
Study Contact Backup
- Name: David Whaley
- Phone Number: 714-456-5501
- Email: whaleyd@hs.uci.edu
Study Locations
-
-
California
-
Orange, California, United States, 92868
- UC Irvine Medical Center
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age 18 or older
- Laparoscopic bowel resection surgery under general anesthesia with nondepolarizing neuromuscular blockade with rocuronium or vecuronium, and requiring inpatient admission
Exclusion Criteria:
- Allergy to Rocuronium, Vecuronium, or Sugammadex
- Bowel resection surgery requiring an ostomy
- No severe valvulopathy, no systolic heart failure with reduced ejection fraction (HFrEF), no coronary artery disease with positive stress test for ischemic regional wall motion abnormality
- No autoimmune pulmonary disease, no severe pulmonary fibrosis, no severe pulmonary hypertension, no COPD with requirement of home oxygen, no pulmonary cancer of primary or metastatic origin
- Creatinine Clearance (CrCl) of less than 30
- Pregnancy
- Incapable of providing consent or understanding the research project
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Neostigmine plus Glycopyrrolate
0.07 mg/kg Neostigmine plus 0.014 mg/kg glycopyrrolate 2 syringes numbered 1 and 2
|
Examine GI-2 recovery
Other Names:
|
|
Active Comparator: Sugammadex
2.0 mg/kg of Sugammadex plus saline equivalent 2 syringes numbered 1 and 2
|
Examine GI-2 recovery
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
GI-2 Recovery
Time Frame: Post-surgically until report of first bowel movement
|
GI-2 recovery as defined as hour to first bowel movement and toleration of oral diet
|
Post-surgically until report of first bowel movement
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Time to Out of Bed
Time Frame: Up to 24 hours post surgery
|
Time for patient to be able to get out of bed and walk post surgically
|
Up to 24 hours post surgery
|
|
Cost of Stay
Time Frame: From hospital admission to discharge
|
Total cost of surgical stay
|
From hospital admission to discharge
|
|
Length of Stay
Time Frame: From hospital admission to discharge
|
Total time patient is at hospital
|
From hospital admission to discharge
|
|
Morbidity & Mortality
Time Frame: Up to 30 days post surgery
|
Morbidity was defined as the number of participants with at least one predefined postoperative complication, including postoperative ileus, pulmonary complications, cardiovascular complications, surgical site infection, urinary tract infection, acute kidney injury, thromboembolic events, reoperation, anastomotic leak, wound dehiscence, or postoperative transfusion within 30 days after surgery.
Mortality was defined as all-cause death occurring within 30 days after surgery.
Complications were identified through review of the electronic medical record.
|
Up to 30 days post surgery
|
|
Post Reversal Bradycardia
Time Frame: Post surgically but prior to PACU discharge, up to 24 hours
|
Number of participants experiencing post-reversal bradycardia prior to discharge from PACU
|
Post surgically but prior to PACU discharge, up to 24 hours
|
|
Duration of PACU Stay
Time Frame: From surgical end time to PACU discharge, up to 24 hours
|
Time in PACU, not owing to bed availability.
Defined as time to achieve a sustained Aldrete score ≥8.
|
From surgical end time to PACU discharge, up to 24 hours
|
|
Amount of Fluid Administration
Time Frame: Intraoperative and postoperative including PACU stay, up to 24 hours
|
Total amount of IV fluids administered during and after surgery through PACU stay.
|
Intraoperative and postoperative including PACU stay, up to 24 hours
|
|
Postoperative Nausea and Vomiting
Time Frame: Postoperative to discharge, up to 1 week
|
Number of Participants Experiencing PONV
|
Postoperative to discharge, up to 1 week
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Robert R Field, MD, Associate Clinical Professor
Publications and helpful links
General Publications
- Hristovska AM, Duch P, Allingstrup M, Afshari A. Efficacy and safety of sugammadex versus neostigmine in reversing neuromuscular blockade in adults. Cochrane Database Syst Rev. 2017 Aug 14;8(8):CD012763. doi: 10.1002/14651858.CD012763.
- Ludwig K, Enker WE, Delaney CP, Wolff BG, Du W, Fort JG, Cherubini M, Cucinotta J, Techner L. Gastrointestinal tract recovery in patients undergoing bowel resection: results of a randomized trial of alvimopan and placebo with a standardized accelerated postoperative care pathway. Arch Surg. 2008 Nov;143(11):1098-105. doi: 10.1001/archsurg.143.11.1098.
- Briggs A, Goldberg J. Tips, Tricks, and Technique for Laparoscopic Colectomy. Clin Colon Rectal Surg. 2017 Apr;30(2):130-135. doi: 10.1055/s-0036-1597313.
- Deyhim N, Beck A, Balk J, Liebl MG. Impact of Sugammadex Versus Neostigmine/Glycopyrrolate on Perioperative Efficiency. Clinicoecon Outcomes Res. 2020 Jan 31;12:69-79. doi: 10.2147/CEOR.S221308. eCollection 2020.
- Gray PJ, Goldwag JL, Eid MA, Sacks OA, Wilson LR, Wilson MZ, Ivatury SJ. Does Bowel Function Change After Colectomy for Colon Malignancy? J Surg Res. 2021 Feb;258:283-288. doi: 10.1016/j.jss.2020.09.003. Epub 2020 Oct 8.
- Bhurwal A, Minacapelli CD, Patel A, Mutneja H, Goel A, Shah I, Bansal V, Brahmbhatt B, Das KM. Evaluation of a U.S. National Cohort to Determine Utilization in Colectomy Rates for Ulcerative Colitis Among Ethnicities. Inflamm Bowel Dis. 2022 Jan 5;28(1):54-61. doi: 10.1093/ibd/izab020.
- Deljou A, Soleimani J, Sprung J, Schroeder DR, Weingarten TN. Effects of Reversal Technique for Neuromuscular Paralysis on Time to Recovery of Bowel Function after Craniotomy. Am Surg. 2023 May;89(5):1605-1609. doi: 10.1177/00031348211058631. Epub 2022 Jan 5.
- Booij LH, van Egmond J, Driessen JJ, de Boer HD. In vivo animal studies with sugammadex. Anaesthesia. 2009 Mar;64 Suppl 1:38-44. doi: 10.1111/j.1365-2044.2008.05869.x.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Digestive System Diseases
- Gastrointestinal Diseases
- Intestinal Diseases
- Organic Chemicals
- Heterocyclic Compounds, 1-Ring
- Heterocyclic Compounds
- Carbohydrates
- Polycyclic Compounds
- Amines
- Polysaccharides
- Macrocyclic Compounds
- Phenylammonium Compounds
- Quaternary Ammonium Compounds
- Onium Compounds
- Pyrrolidines
- gamma-Cyclodextrins
- Cyclodextrins
- Dextrins
- Starch
- Glucans
- Glycopyrrolate
- Neostigmine
- Sugammadex
Other Study ID Numbers
Other Study ID Numbers
- 2295
- Field 100931 (Other Identifier: Merck Investigator Initiated Studies Program (MISP))
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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