- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02580188
The Effect of Deep Neuromuscular Block on Surgical Condition During Laparoscopic Colorectal Surgery (DEEPCOL)
March 12, 2019 updated by: BON WOOK KOO, Seoul National University Bundang Hospital
This study is a randomized, controlled, double-blinded, and parallel design study.
A total 96 patients were randomized to receive a deep block or a moderate block scheduled for elective laparoscopic colorectal surgery.
Investigators estimated the proportion of intra-abdominal pressure(IAP) alarm and surgical rating score.
Study Overview
Detailed Description
Patients >18 years of age with an america society of anesthesiologist classification of I or II who were scheduled to undergo elective laparoscopic colorectal surgery were included.
The exclusion criteria were a history of neuromuscular, renal, or hepatic disease, a history of low abdominal surgery; treatment with drugs known to interfere with neuromuscular function.
Patients were randomised to either the moderate or deep neuromuscular blockade group using Random Allocation Software (version 1.0).
Premedication with intravenous midazolam at 0.03 mg/kg was performed in the reception area.
In the operating room, routine monitoring was performed, including electrocardiography, non-invasive arterial pressure measurements, and pulse oximetry.
Additionally, acceleromyography was applied to monitor the response of the corrugator supercilii muscle.
Neuromuscular management and monitoring were performed according to the Good Clinical Research Practice guidelines.
After the induction of anaesthesia with propofol and remifentanil using target-controlled infusers and before rocuronium administration, the TOF-Watch-SX was calibrated and stabilised; a 50-Hz tetanic stimulation was applied for 5 s, the TOF-Watch-SX was calibrated, and a series of train-of-four (TOF) measurements were documented for >2 min until a stable baseline was obtained (<5% variation in the TOF ratios).
Next, intravenous rocuronium at 0.6 mg/kg was administered, and tracheal intubation was performed after confirmation of relaxation.
Anesthesia was maintained with desflurane and target-controlled infusion of remifentanil while monitoring the bispectral index.
A continuous dose of intravenous rocuronium (10-60 mg/hr) was used to maintain moderate (TOF count of 1 or 2) or deep (post-tetanic count [PTC] of 1 or 2) neuromuscular blockade.
The IAP alarm(IAP>15mmHg) rate were checked.
Any movement during the operation as reported by the surgeon or anaesthesiologist was recorded.
At the end of the operation, the surgeon rated the surgical condition on a 5-point scale.
Patients in the moderate group were reversed with neostigmine at 50 µg/kg and glycopyrrolate at 10 µg/kg at a TOF count of 1 or 2, and patients in the deep group were reversed with intravenous sugammadex at 4 mg/kg at PTC of 1 or 2. The time from administration of the reversal agents to a TOF ratio of 0.9 was recorded.
Postoperative pain and opioid consumption were evaluated at 24, 48h postoperatively.
Postoperative nausea and/or vomiting, dry mouth, were also evaluated at the same time points.
Study Type
Interventional
Enrollment (Actual)
70
Phase
- Phase 4
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
Genders Eligible for Study
All
Description
Inclusion Criteria:
- American Society of Anesthesiologists grade 1 or 2
- Scheduled for elective laparoscopic Colorectal surgery
Exclusion Criteria:
- Severe respiratory or cardiac disease
- Severe hepatic or renal function impairment
- On medications affecting neuromuscular function
- Known allergy to the drugs to be used
- Pregnant
- Malignant hyperthernia
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: Other
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
No Intervention: Moderate block
Maintenance dose of 0.15-0.3
mg/kg/hr rocuronium as continuous infusion during surgery for the maintenance of train of four count 1-2 (moderate block).
At the end of surgery neostigmine 50 ㎍/kg with glycopyrrolate 10 ㎍/kg are administered IV for reversal of neuromuscular block.
|
|
Experimental: Deep block
Maintenance dose of 0.4-0.9
mg/kg/hr rocuronium as continuous infusion during surgery for the maintenance of post tetanic count 1-2 (deep block).
At the end of surgery, sugammadex 4 mg/kg are administered IV for reversal of neuromuscular block
|
Maintenance dose of 0.4-0.9
mg/kg/hr rocuronium as continuous infusion during surgery for the maintenance of post tetanic count 1-2 (deep block).
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of Participants With Increased Intra-abdominal Pressure (IAP) Alarm as > 15 mmHg
Time Frame: intraoperative, an averrage of 3 hour
|
Intra-abdominal pressure was maintained at 12 mmHg during pneumoperitoneum(using the carbon dioxide gas insufflation) and the pressure alarm for IAP was set at < 15 mmHg. Intra-abdominal pressure is measured in a separate machine connected to a carbon dioxide gas injection line. |
intraoperative, an averrage of 3 hour
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Postoperative Pain is Evaluated by Verbal Numerical Rating Scale (VNRS, 0 = no Pain, 10 = the Severest Pain Imaginable)
Time Frame: 24hr after end of operation
|
Postoperative pain is controlled by IV patient controlled analgesia using fentanyl.
If patient complain of severe pain (VNRS score of 7 or more), additional analgesics can be used according to the attending physician.
|
24hr after end of operation
|
Postoperative Pain is Evaluated by Verbal Numerical Rating Scale (VNRS, 0 = no Pain, 10 = the Severest Pain Imaginable)
Time Frame: 48hr after end of operation
|
Postoperative pain is controlled by IV patient controlled analgesia using fentanyl.
If patient complain of severe pain (VNRS score of 7 or more), additional analgesics can be used according to the attending physician.
|
48hr after end of operation
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Study Chair: Ah-Young Oh, MD.,Ph.D., Seoul National Univ. Bundang Hospital
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)
March 24, 2015
Primary Completion (Actual)
June 16, 2016
Study Completion (Actual)
June 18, 2016
Study Registration Dates
First Submitted
September 30, 2015
First Submitted That Met QC Criteria
October 19, 2015
First Posted (Estimate)
October 20, 2015
Study Record Updates
Last Update Posted (Actual)
March 13, 2019
Last Update Submitted That Met QC Criteria
March 12, 2019
Last Verified
March 1, 2019
More Information
Terms related to this study
Other Study ID Numbers
- DNMBC-SNUBH
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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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