Muscle Relax Affects Outcomes of Robotic Surgery (MORE)

October 29, 2018 updated by: Zhihong LU, Air Force Military Medical University, China

Effect of Neuromuscular Blockade Protocol on Perioperative Outcomes of Robotic Laparoscopic Surgery

During robotic laparoscopic surgery, a high intraperitoneal pressure may result in high airway pressure and inadequate perfusion of the abdominal organs, and as a result the postoperative outcomes. Degree of neuromuscular blockade (NMB) can affect the intraperitoneal pressure. In this study, the patients undergoing robotic laparoscopic surgery will be assigned to deep NMB group and moderate NMB group. Perioperative outcomes including maximal intraperitoneal pressure, maximal intraoptic pressure, quality of emergence, postoperative pain, and incidence of postoperative respiratory complication will be compared. The results of this study will provide evidence for optimizing NMB protocol of robotic laparoscopic surgery.

Study Overview

Status

Unknown

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Anticipated)

192

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.

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 to 80 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • patients scheduled for elective robotic laparoscopic surgery under general anesthesia
  • American Society of Anesthesiologists status 1-2
  • Body mass index of 18-30kg/m2
  • Patients scheduled to be positioned in trendelenburg position during surgery

Exclusion Criteria:

  • Patients allergic to rocuronium
  • Patients with neuromuscular dysfunction
  • Patients with existed pulmonary diseases
  • Patients with hepatic or renal dysfunction

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: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: deep neuromuscular blockade
Rocuronium, a neuromuscular blocking agent will be given by continuous infusion at a dose that reaction to train of four (TOF) stimulation is depressed to zero
Drug: Rocuronium
rocuronium is a neuromuscular blocking agent with a duration of 40 minutes
Other Names:
  • rocuronium bromide
Other: continuous infusion
rocuronium is continuously infused
Other Names:
  • high dose
Experimental: moderate neuromuscular blockade
Rocuronium, a neuromuscular blocking agent will be given at a dose by intermittent injection that reaction to train of four (TOF) stimulation is kept 1 to 2
Drug: Rocuronium
rocuronium is a neuromuscular blocking agent with a duration of 40 minutes
Other Names:
  • rocuronium bromide
Other: intermittent injection
rocuronium is intermittently given
Other Names:
  • low dose

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
incidence of postoperative major respiratory complications
Time Frame: from end of surgery to discharge, at an average of 4 days
incidence of pneumonia and atelectasis
from end of surgery to discharge, at an average of 4 days

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
maximal airway pressure
Time Frame: from establishment of pneumoperitoneum to end of pneumoperitoneum, at an average of 3 hours
airway pressure is titrated to as low as possible as long as the end tidal carbon dioxide partial pressure is lower than 40 mmHg
from establishment of pneumoperitoneum to end of pneumoperitoneum, at an average of 3 hours
minimal cerebral oxygen saturation
Time Frame: from start of surgery to end of surgery, at an average of 3.5 hours
cerebral oxygen saturation is continuously monitored during surgery
from start of surgery to end of surgery, at an average of 3.5 hours
maximal intraocular pressure
Time Frame: from start of surgery to end of surgery, at an average of 3.5 hours
intraocular pressure is monitored every 10 minutes during surgery
from start of surgery to end of surgery, at an average of 3.5 hours
number of surgeon asking for improving muscle relax
Time Frame: from start of surgery to end of surgery, at an average of 3.5 hours
when the surgeon is unsatisfied with the muscle relax, he can tell the anesthetist
from start of surgery to end of surgery, at an average of 3.5 hours
time to extubation
Time Frame: from end of sevoflurane inhalation to extubation, at an average of 20 minutes
criteria of extubation: spontaneous respiratory rate>10 per minute and end tidal carbon dioxide partial pressure<45mmHg
from end of sevoflurane inhalation to extubation, at an average of 20 minutes
incidence of nausea and vomiting in post-anesthesia care unit
Time Frame: from admittance to post-anesthesia care unit(PACU) to discharge from PACU, at an average of 30 minutes
from admittance to post-anesthesia care unit(PACU) to discharge from PACU, at an average of 30 minutes
incidence of shoulder pain in 24 hours after surgery
Time Frame: from end of surgery to 24 hours after surgery
from end of surgery to 24 hours after surgery
incidence of residual neuromuscular blockade in the post-anesthesia care unit
Time Frame: from admittance to post-anesthesia care unit(PACU) to discharge from PACU, at an average of 30 minutes
residual neuromuscular blockade is defined as time of head-lift or limb-lift<10 seconds
from admittance to post-anesthesia care unit(PACU) to discharge from PACU, at an average of 30 minutes
visual analogue scale at 24 hours after surgery
Time Frame: end of surgery to 24 hours after surgery
the patients are asked to mark the score they feel, 0 is no pain,100 is untolerated pain
end of surgery to 24 hours after surgery
expense after surgery
Time Frame: end of the surgery to discharge,at an average of 4 days
the expense from immediately after surgery to discharge
end of the surgery to discharge,at an average of 4 days
satisfaction score of the patients
Time Frame: from end of surgery to discharge,at an average of 4 days
the patient is asked to give a score between 0 and 10, 0 means not satisfied,10 means totally satisfied.
from end of surgery to discharge,at an average of 4 days

Collaborators and Investigators

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

Sponsor

Air Force Military Medical University, China

Investigators

  • Principal Investigator: Zhihong Lu, Xijing Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

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 (Anticipated)

November 10, 2018

Primary Completion (Anticipated)

November 10, 2019

Study Completion (Anticipated)

November 10, 2019

Study Registration Dates

First Submitted

October 28, 2018

First Submitted That Met QC Criteria

October 29, 2018

First Posted (Actual)

October 31, 2018

Study Record Updates

Last Update Posted (Actual)

October 31, 2018

Last Update Submitted That Met QC Criteria

October 29, 2018

Last Verified

October 1, 2018

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • XJH-A-20180701

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

After publishing, data of the primary endpoint and second endpoints can be shared with other researchers

IPD Sharing Time Frame

When the results have been published in peer-reviewed journals, the data will be available. The planned time frame will be 5 years.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP
  • ICF
  • CSR

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

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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