- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03111121
Use of Sugammadex for Reversal of Paralysis in Microlaryngoscopy
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This is a prospective, clinical interventional, randomized single blinded single center study.
Hypotheses:
Primary Hypothesis: Use of Muscle relaxant and reversal with Sugammadex at end of airway procedures will reduce the time to extubation after end of procedure
Secondary Hypotheses:
Surgeon will report optimal surgical conditions for ease of exposure
Have less hemodynamic changes in the OR and PACU. ∆ in BP, HR and CO2 from base-line and incidence /frequency of 20% change in BP from baseline vitals (baseline= pre-induction vitals)
Decrease the amount of inhaled anesthetics
Decreased narcotics needed intra-operatively and post operatively
Decrease the total OR time
Subjects will meet ALDRETE PACU discharge criteria quicker in the PACU
Subject will have less adverse events and severe adverse events such as - hypotension, arrhythmia, hypoxia, stridor and re-intubation.
We note that the nurses in PACU will be blinded to whether the subjects were in Group 1 or 2.
Group 1: Inhaled anesthetics: sevoflurane at 1 MAC, remifentanil and intubation with rocuronium at 0.6-1.2 mg/kg (vitals maintained within 20% of baseline). Group 1 will receive reversal with neostigmine (0.04 mg/kg and glycopyrrolate (0.01 mg/kg)
Group 2: Inhaled anesthetics: sevoflurane at 1 MAC, remifentanil and intubation with rocuronium at 0.6 -1.2 mg/kg (vitals maintained within 20% of baseline). Group 2 will receive reversal with sugammadex 4mg/kg
Both groups will receive standard anti-nausea prophylaxis - Ondansetran and Decadran intraoperative.
After induction, the amount of inhaled anesthetic and remifentanil used will be titrated based on hemodynamic parameters (maintained within 20% from baseline) and a BIS monitor.
All subjects will have TOF testing done every 5 minutes throughout the procedure and tabulated in the Electronic Medical Record (EMR).
At the end of the procedure patient will be extubated when the subject meets the following criteria:
Tidal volume : > 5 cc /Kg Respiratory rate: >8 /min O2sat > 95% ON 100% inspired oxygen
With vitals at 20% of baseline. Extubation will begin when the surgeon states, "We are done". This usually coincides with the withdrawal of the scope. The start and end times for extubation will be recorded in the Electronic Medical Record.
The PACU nurses will evaluate ALDRETE discharge criteria and make a note in the electronic medical records for the subject discharge time from PACU. The nurses in PACU will be the only evaluators of the subject who will be blinded to the two groups
Study Type
Enrollment (Anticipated)
Phase
- Phase 4
Contacts and Locations
Study Contact
- Name: Pavithra Ranganathan, MD
- Phone Number: 304-598-4929
- Email: ranganathanp@wvumedicine.org
Study Contact Backup
- Name: Connie Tennant, RN, CCRP
- Phone Number: 304-598-4737
- Email: cstennant@hsc.wvu.edu
Study Locations
-
-
West Virginia
-
Morgantown, West Virginia, United States, 26506
- Recruiting
- WVU Healthcare Ruby Memorial Hospital
-
Contact:
- Pavithra Ranganathan, MD
- Phone Number: 304-598-4929
- Email: ranganathanp@wvuhealthcare.com
-
Contact:
- Matthew Ellison, MD
- Phone Number: 304-598-4929
- Email: EllisonMa@wvuhealthcare.com
-
Principal Investigator:
- Pavithra Ranganathan, MD
-
Sub-Investigator:
- Matthew Ellison, MD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
Microlaryngoscopy or rigid bronchoscopy for vocal cord and tracheal procedures
Age 18 years or older,
ASA physical status I-III
Ability to give written informed consent.
Exclusion Criteria:
Known or suspected neuromuscular disease/pre-existing weakness,
Creatinine clearance less than 30 ml/min
Bradycardia of less than 40 beats/min,
Pregnancy, breast feeding women
Known or suspected allergy to BRIDION® (sugammadex), neostigmine or rocuronium.
Patients with contraindications towards sugammadex, neostigmine or rocuronium
Patients included in another trial within the last 30 days
Patients with legal guardians or surrogate decision making
Patients who refuse to use non-hormonal contraceptive method or back-up method of contraception (such as condoms and spermicides) for the next 7 days if receiving sugammadex.
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Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Group 1
Reversal of Paralysis in Microlaryngoscopy procedures: Inhaled anesthetics: sevoflurane at 1 MAC, remifentanil and intubation with rocuronium at 0.6-1.2
mg/kg (vitals maintained within 20% of baseline).
Standard anti-nausea prophylaxis - Ondansetran and Decadran intraoperative.After induction; amount of inhaled anesthetic and remifentanil used will be titrated based on hemodynamic parameters (maintained within 20% from baseline) and a BIS monitor.TOF testing done every 5 minutes:Group 1 will receive reversal with neostigmine (0.04 mg/kg and glycopyrrolate (0.01 mg/kg)
|
receive reversal with neostigmine 0.04 mg/kg
receive reversal with glycopyrrolate (0.01 mg/kg)
|
Active Comparator: Group 2
Reversal of Paralysis in Microlaryngoscopy procedures: Inhaled anesthetics: sevoflurane at 1 MAC, remifentanil and intubation with rocuronium at 0.6-1.2
mg/kg (vitals maintained within 20% of baseline).
Standard anti-nausea prophylaxis - Ondansetran and Decadran intraoperative.After induction; amount of inhaled anesthetic and remifentanil used will be titrated based on hemodynamic parameters (maintained within 20% from baseline) and a BIS monitor.TOF testing done every 5 minutes: Group2 will receive reversal with sugammadex 4mg/kg
|
receive reversal with sugammadex 4mg/kg
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Time to extubation after end of procedure
Time Frame: intraoperative
|
West Virginia University Hospitals use an electronic medical record (EMR) to chart the end of the procedure.
When the surgeon states "We are done", always at withdrawal of the scope, extubation begins.
From the time we chart end of procedure to the time of extubation is the extubation time.
The start and end times for extubation will be recorded in the EMR.
|
intraoperative
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
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
- Nervous System Diseases
- Neurologic Manifestations
- Paralysis
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Autonomic Agents
- Peripheral Nervous System Agents
- Muscarinic Antagonists
- Cholinergic Antagonists
- Cholinergic Agents
- Enzyme Inhibitors
- Adjuvants, Anesthesia
- Cholinesterase Inhibitors
- Parasympathomimetics
- Glycopyrrolate
- Neostigmine
Other Study ID Numbers
- 1610312153
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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