- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04947306
A Comparison Between TOF Watch® SX and Tetragraph®
June 23, 2021 updated by: Fondazione IRCCS Istituto Nazionale dei Tumori, Milano
A Comparison of Accelerometric Monitoring by TOF Watch® SX and Electromyographic Monitoring by Tetragraph® for Recovery From Neuromuscular Blockade
This observational study was designed to assess the agreement between the recently marketed electromyographic neuromuscular blockade monitor Tetragraph® (Senzime, Uppsala, Sweden) and the TOF Watch® SX (Organon Teknika B.V., Boxtel, Holland), an accelerometric neuromuscular blockade monitor frequently used in clinical practice
Study Overview
Status
Completed
Conditions
Detailed Description
Before the induction of general anesthesia both monitors will be placed in the same arm.
After induction of general anesthesia and before neuromuscular blocking agent administration both devices will be consecutively calibrated and a baseline measurement will be obtained.
During the surgical procedure the investigators will monitor neuromuscular function with one of the two devices.
Then the investigators will switch the device used as a guide between subsequent patients.
The protocol will start as soon as the leading device will register a train-of-four ratio (TOFr) ≥ 0.2.
During the protocol a comparison between the two devices will be conducted as soon as the device used as a guide will display a TOFr ≥ 0.2, 0.3, 0.4, 0.5, 0.6, 0.7, 0.8, 0.9, 1.
For each of the TOFr reported, we will deliver two subsequent TOF stimulations with the guiding device followed by two TOF stimulations with the other monitor.
Both the stimulations delivered by each device and the two consecutive stimulations delivered by different monitors will be conducted 20 sec from one another.
Stimulations with the same device will be used to assess intraobserver variability for each methodology, while the second and the third measurements (consecutive stimulations with different devices) will be used to assess agreement between them.
The protocol will end when the leading device will show a TOFr ≥ 1.0, or if, at the end of the surgical procedure, acceleromyographic TOFr will be > 0.9.
Study Type
Observational
Enrollment (Actual)
20
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
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Mi
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Milan, Mi, Italy, 20133
- Fondazione IRCCS Istituto Nazionale dei Tumori
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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
Sampling Method
Probability Sample
Study Population
Adult patients >18 years of age, who are scheduled to undergo any elective procedure under general anesthesia at our Institution in which the administration of rocuronium for neuromuscular blockade is anticipated.
Description
Inclusion Criteria:
- age > 18 years
- Rocuronium bromide use is anticipated for neuromuscular blockade during surgical procedure
- Upper arms will be freely available during the surgical procedure
Exclusion Criteria:
- Known neuromuscular disease
- Known allergy to Rocuronium bromide
- end-stage liver disease
- chronic kidney disease
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
- Observational Models: Cohort
- Time Perspectives: Prospective
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
All subjects
Adult patients >18 years of age, who are scheduled to undergo any elective procedure under general anesthesia at our Institution in which the administration of rocuronium for neuromuscular blockade is anticipated. All participants will be monitored with both TOF Watch and Tetragraph neuromuscular monitors. |
The Tetragraph® is a recently marketed electromyographic neuromuscular monitor that uses a disposable electrode array (TetraSens) that combines stimulating and recording electrodes
Other Names:
The TOF Watch® SX is a common used neuromuscular monitor
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Agreement between TOF Watch® SX and Tetragraph® train-of-four ratios
Time Frame: Recovery from neuromuscular blockade at the end of the surgical procedure
|
Bias and Limits of Agreement between the two methodologies using Bland-Altman analysis
|
Recovery from neuromuscular blockade at the end of the surgical procedure
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Agreement between normalized TOF Watch® SX and Tetragraph® train-of-four ratios
Time Frame: Recovery from neuromuscular blockade at the end of the surgical procedure
|
Normalized TOF Watch® SX train of four ratios will be calculated as the ratio between actual train-of-four ratio and baseline.
Bias and Limits of Agreement will be derived using Bland-Altman analysis
|
Recovery from neuromuscular blockade at the end of the surgical procedure
|
Agreement between TOF Watch® SX and Tetragraph® train-of-four ratios for TOF ratios < 0.8
Time Frame: Recovery from neuromuscular blockade at the end of the surgical procedure
|
Normalized TOF Watch® SX train of four ratios will be calculated as the ratio between actual train-of-four ratio and baseline.
Bias and Limits of Agreement will be derived using Bland-Altman analysis
|
Recovery from neuromuscular blockade at the end of the surgical procedure
|
Agreement between TOF Watch® SX and Tetragraph® train-of-four ratios for TOF ratios ≥ 0.8
Time Frame: Recovery from neuromuscular blockade at the end of the surgical procedure
|
Normalized TOF Watch® SX train of four ratios will be calculated as the ratio between actual train-of-four ratio and baseline.
Bias and Limits of Agreement will be derived using Bland-Altman analysis
|
Recovery from neuromuscular blockade at the end of the surgical procedure
|
Absolute and relative intraobserver variability for TOF Watch® SX and Tetragraph®
Time Frame: Recovery from neuromuscular blockade at the end of the surgical procedure
|
Absolute intraobserver variability will be calculated as the absolute difference between pairs of consecutive measurements by the same device.
Relative intraobserver variability will be calculated as the ratio between the absolute difference and mean of the measurements.
|
Recovery from neuromuscular blockade at the end of the surgical procedure
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
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)
August 24, 2020
Primary Completion (Actual)
October 30, 2020
Study Completion (Actual)
October 30, 2020
Study Registration Dates
First Submitted
June 15, 2021
First Submitted That Met QC Criteria
June 23, 2021
First Posted (Actual)
July 1, 2021
Study Record Updates
Last Update Posted (Actual)
July 1, 2021
Last Update Submitted That Met QC Criteria
June 23, 2021
Last Verified
June 1, 2021
More Information
Terms related to this study
Other Study ID Numbers
- INT58/20
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
No
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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