- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02703909
Surgical Conditions During Laparoscopic Bariatric Surgery
A Prospective Randomized Clinical Trial Evaluating Surgical Conditions During Laparoscopic Bariatric Surgery With Deep Versus Moderate Neuromuscular Blockade
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Subjects will be randomized to one of four groups:
- moderate neuromuscular block (NMB) + 10 mm insufflation pressure (IP);
- moderate NMB + 15 mm IP;
- deep NMB + 10 mm IP; or
- deep NMB + 15 mm IP.
A moderate NMB block will be defined as 2-3 twitches in the train of four (TOF) and a deep NMB will be defined as 0-1 posttetanic count. The surgeons will be asked to rate their satisfaction with the surgical conditions using a five-point ordinal scale ranging from 1 (extremely poor) to 5 (optimal conditions). The first rating will occur at the beginning of the procedure when the NMB level is stable at either a deep or moderate block and the intra-abdominal pressure is either 10 or 15 mm Hg (per randomization). The surgeon will be blinded to the insufflation pressure at this point. If the surgical conditions are rated as extremely poor or poor, the level of the neuromuscular block can be increased and/or the insufflation pressure can be increased to 15 mm Hg.
Study Type
Enrollment (Actual)
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
Missouri
-
Columbia, Missouri, United States, 65212
- University Hospital
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age ≥ 18 years
- ASA I-III
- BMI ≥ 35
Exclusion Criteria:
- Inability to obtain written informed consent
- Pregnancy or breastfeeding
- Allergy to rocuronium, sugammadex, or any anesthetic agents used in the protocol
- Known or suspected neuromuscular disorders
- Significant renal disease with a serum creatinine ≥ 2 mg/dl f. Significant liver disease g. A family history of malignant hyperthermia
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Health Services Research
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: moderate NMB + 10 mm IP
participants will be given the muscle relaxant, rocuronium, iv to obtain a moderate neuromuscular block (NMB) which is defined as 2-3 twitches in the train of four on a neuromuscular junction monitor.
The initial insufflation pressure for the laparoscopy will be 10 mm Hg pressure.
|
Rocuronium will be administered to achieve either a moderate (2-3 twitches) or deep (0-1 posttetanic) block depending on the group assignment
Other Names:
The initial insufflation pressure will be set at either 10 or 15 mm Hg depending on the group assignment
Other Names:
|
Active Comparator: moderate NMB + 15 mm IP
participants will be given the muscle relaxant, rocuronium, iv to obtain a moderate NMB which is defined as 2-3 twitches in the train of four on a neuromuscular junction monitor.
The initial insufflation pressure for the laparoscopy will be 15 mm Hg pressure.
This arm represents the usual operating conditions for this type of surgery at the University hospital.
|
Rocuronium will be administered to achieve either a moderate (2-3 twitches) or deep (0-1 posttetanic) block depending on the group assignment
Other Names:
The initial insufflation pressure will be set at either 10 or 15 mm Hg depending on the group assignment
Other Names:
|
Experimental: deep NMB + 10 mm IP
participants will be given the muscle relaxant, rocuronium, iv to obtain a deep NMB which is defined as 0-1 posttetanic counts on a neuromuscular junction monitor and the initial insufflating pressure will be 10 mm Hg.
The initial insufflation pressure for the laparoscopy will be 10 mm Hg pressure.
|
Rocuronium will be administered to achieve either a moderate (2-3 twitches) or deep (0-1 posttetanic) block depending on the group assignment
Other Names:
The initial insufflation pressure will be set at either 10 or 15 mm Hg depending on the group assignment
Other Names:
|
Experimental: deep NMB + 15 mm IP
participants will be given the muscle relaxant, rocuronium, iv to obtain a deep NMB which is defined as 0-1 posttetanic counts on a neuromuscular junction monitor and the initial insufflating pressure will be 15 mm Hg.
The initial insufflation pressure for the laparoscopy will be 10 mm Hg pressure.
|
Rocuronium will be administered to achieve either a moderate (2-3 twitches) or deep (0-1 posttetanic) block depending on the group assignment
Other Names:
The initial insufflation pressure will be set at either 10 or 15 mm Hg depending on the group assignment
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Surgeon Satisfaction Scale
Time Frame: day of surgery
|
The surgeon will grade his satisfaction with the surgical conditions using a 5 point scale with 1 - extremely poor; 2 - poor; 3 - acceptable; 4. good; 5 - optimal surgical conditions
|
day of surgery
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number and Percentage of Subjects With Success at Low (10 mm) Insufflation Pressure
Time Frame: day of surgery
|
The patients will be randomized to an initial insufflation pressure of 10 or 15 mm hg.
If the surgeons are not satisfied with the initial operating conditions, the insufflating pressure will be increase to 15 mm Hg (if not already at that level).
This will be reported as the percentage of patients who were able to have their entire surgery performed at an insufflation pressure of 10 mm Hg.
|
day of surgery
|
Postoperative Opioid Requirement
Time Frame: day of surgery until hospital discharge (approximately 2-3 days)
|
The participants will be given iv fentanyl or hydromorphone after surgery.
They will also be given po oxycodone.
The investigators will collect data on the amount of opioid that is required after surgery.
This will be reported as morphine equivalents using the morphine equivalent calculator at:
|
day of surgery until hospital discharge (approximately 2-3 days)
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Terri G Monk, MD, University of Missouri-Columbia
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2004620
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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.
Clinical Trials on Morbid Obesity
-
ClinTrio Ltd.UnknownMorbid Obesity Requiring Bariatric SurgeryBelgium, Germany, Portugal, Austria, Netherlands, Poland, Saudi Arabia
-
Centre Hospitalier Universitaire de NiceCompletedMorbid Obesity D009765France
-
Shanghai Jiao Tong University School of MedicineUnknown
-
Norwegian School of Sport SciencesHjelp24Completed
-
Hospices Civils de LyonCentre de Recherche en Nutrition Humaine Rhone-Alpe; Institut National de Recherche... and other collaboratorsRecruiting
-
Endolumik, IncWest Virginia UniversityNot yet recruitingMorbid ObesityUnited States
-
Laval UniversityCentre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie...Recruiting
-
Rijnstate HospitalActive, not recruiting
-
University of WashingtonUnited States Department of DefenseWithdrawn
-
Helsinki University Central HospitalActive, not recruiting
Clinical Trials on Rocuronium
-
Radboud University Medical CenterMerck Sharp & Dohme LLCUnknown
-
Medtronic - MITGCompletedAnesthesia | Neuromuscular BlockadeUnited States
-
University of RostockCompletedObservation of Neuromuscular Block | Complication of Ventilation TherapyGermany
-
Sheba Medical CenterUnknown
-
Pontificia Universidad Catolica de ChileCompletedNeuromuscular Blockade
-
Indiana UniversityCompleted
-
Memorial Sloan Kettering Cancer CenterRecruitingProstate CancerUnited States
-
Asan Medical CenterCompletedNeuromuscular BlockadeKorea, Republic of
-
Rigshospitalet, DenmarkCompletedA Comparison of Rocuronium 0.3 mg/kg, and 0.9 mg/kg for Induction of Anesthesia in Elderly Patients.Anesthesia | Intubation Complication | Neuromuscular Blockade | Neuromuscular Blockade, ResidualDenmark
-
SMG-SNU Boramae Medical CenterUnknownSore ThroatKorea, Republic of