The Effect of Neostigmine and Sugammadex on the Optic Nerve Sheath Diameter
Comparison of the Effects of Neostigmine and Sugammadex on the Optic Nerve Sheath Diameter During the Postoperative Extubation Period
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
The study will be conducted prospectively, randomly, and double-blind on a total of 86 patients aged 18-65 years, classified as ASA 1-2, undergoing elective surgery at the Department of Anesthesiology and Reanimation, Faculty of Medicine, Çukurova University. Written and verbal informed consent will be obtained from all participants prior to the study.
The demographic data, such as age, gender, body weight, and height, as well as ASA score and information on comorbidities, will be recorded for the patients included in the study in the preoperative anesthesia care unit. All patients who will be taken to the operating room without premedication will undergo routine monitoring, including electrocardiography, noninvasive blood pressure monitoring, and peripheral oxygen saturation. During induction of anesthesia, propofol IV 2 mg/kg, rocuronium IV 0.6 mg/kg, and fentanyl IV 1 mcg/kg will be used. After observing adequate muscle relaxation with a TOF (Train-of-Four) monitor, tracheal intubation will be performed. All patients will receive mechanical ventilation after intubation. During anesthesia, a gas mixture of 2% sevoflurane, 60% nitrous oxide, and 40% oxygen will be administered at a flow rate of 2 L/min. To maintain muscle relaxation throughout the surgery, when a TOF of 2 is observed, 0.2 mg/kg of rocuronium IV will be administered. Tramadol 2 mg/kg IV will be given 45 minutes before the end of surgery for postoperative pain management. Ondansetron 8 mg IV will be planned as antiemetic treatment. At the end of the surgery, the maintenance gases will be discontinued, and according to the randomization, the anesthesiologist responsible for anesthesia administration will either administer 2 mg/kg Sugammadex IV or 0.05 mg/kg Neostigmine IV plus 0.02 mg/kg atropine sulfate IV. Patients who show a TOF value of 90% and clinically adequate respiration will be extubated.
In addition to the anesthesiologist responsible for administering anesthesia, one blinded evaluator for each group will perform three ultrasound measurements on both eyes to determine the Optic nerve sheath diameter at 5 minutes after endotracheal intubation, 5 minutes before extubation, and 5 minutes after extubation. The measurements will be recorded while the patient is in a supine position, with ultrasound gel applied to the eyelid, using a linear probe without applying pressure to the eyeball.
The diameter of the optic nerve sheath will be systematically measured at a point 3.0 mm posterior to the optic disc to ensure consistent anatomical evaluation.
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Fase 4
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Ersel Gulec, MD
- Telefonnummer: 3289 +903223386060
- E-mail: gulecersel@yahoo.com
Studiesteder
-
-
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Adana, Tyrkiet (Türkiye)
- Rekruttering
- Cukurova University Faculty of Medicine
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Ledende efterforsker:
- Ersel Gulec, MD
-
Underforsker:
- Mediha Turktan, MD
-
Underforsker:
- Zehra Hatipoglu, MD
-
Underforsker:
- Dilek Ozcengiz, MD
-
Kontakt:
- Ersel Gulec, MD
- Telefonnummer: 3289 +903223386060
- E-mail: gulecersel@yahoo.com
-
Underforsker:
- Kubra Gunsur, MD
-
Underforsker:
- Demet Lafli Tunay, MD
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- With an ASA physical status of 1-2
- Patients scheduled for elective surgery
- Patients willing to participate in the study
Exclusion Criteria:
- Patients with heart, liver, kidney, or respiratory failure
- Brain tumors, hemorrhages, or aneurysms
- Patients who have undergone eye, cardiovascular, or neurosurgery
- Eye or neurological diseases or increased intracranial pressure
- Laparoscopic surgeries
- Cases not in the supine position
- Allergy to the medications used
- Patients who did not provide informed consent to participate in the study.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Dobbelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
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Aktiv komparator: Group S
Sugammadex, intravenous, 2 mg/kg, single bolus dose.
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Intravenous bolus injection
|
|
Aktiv komparator: Group N
Neostigmine, intravenous, 0.05 mg/kg, single bolus dose.
Atropine sulfate, intravenous, 0.02 mg/kg, single bolus dose.
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Intravenous bolus injection
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Change in average optic nerve sheath diameter from intubation to the 5th minute after extubation
Tidsramme: From the time of endotracheal intubation until 5 minutes after extubation
|
Three measurements will be taken for each eye using ultrasound to determine the diameter of the optic nerve sheath at 5 minutes after endotracheal intubation, 5 minutes before extubation, and 5 minutes after extubation; the average values for each eye will be recorded.
Subsequently, the averages of the measurements obtained for both eyes will be calculated.
Changes in these averages over time will be compared between groups.
|
From the time of endotracheal intubation until 5 minutes after extubation
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Blood Pressure
Tidsramme: From the time of endotracheal intubation until 5 minutes after extubation
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Blood pressure will be measured and recorded 5 minutes after endotracheal intubation, 5 minutes before extubation, and 5 minutes after extubation
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From the time of endotracheal intubation until 5 minutes after extubation
|
|
Postoperative nausea and vomiting
Tidsramme: The one-hour period from endotracheal tube removal to patient discharge from the postoperative care unit.
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The number of patients who experienced nausea and vomiting upon waking from anesthesia and during their stay in the postoperative care unit.
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The one-hour period from endotracheal tube removal to patient discharge from the postoperative care unit.
|
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Blood pressure
Tidsramme: The one-hour period from endotracheal tube removal to patient discharge from the postoperative care unit.
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Noninvasive measurement of blood pressure
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The one-hour period from endotracheal tube removal to patient discharge from the postoperative care unit.
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Ledende efterforsker: Ersel Gulec, MD, Cukurova University
Publikationer og nyttige links
Generelle publikationer
- Rajajee V, Vanaman M, Fletcher JJ, Jacobs TL. Optic nerve ultrasound for the detection of raised intracranial pressure. Neurocrit Care. 2011 Dec;15(3):506-15. doi: 10.1007/s12028-011-9606-8.
- Maissan IM, Dirven PJ, Haitsma IK, Hoeks SE, Gommers D, Stolker RJ. Ultrasonographic measured optic nerve sheath diameter as an accurate and quick monitor for changes in intracranial pressure. J Neurosurg. 2015 Sep;123(3):743-7. doi: 10.3171/2014.10.JNS141197. Epub 2015 May 8.
- P S L, Miskan MM, Y Z C, Zaki RA. Staggering the dose of sugammadex lowers risks for severe emergence cough: a randomized control trial. BMC Anesthesiol. 2017 Oct 11;17(1):137. doi: 10.1186/s12871-017-0430-3.
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
- Organiske kemikalier
- Heterocykliske forbindelser
- Kulhydrater
- Alkaloider
- Polycykliske forbindelser
- Aminer
- AZA -forbindelser
- Polysaccharider
- Makrocykliske forbindelser
- Phenylammoniumforbindelser
- Kvaternære ammoniumforbindelser
- Oniumforbindelser
- Gamma-cyclodextriner
- Cyclodextriner
- Dextrins
- Stivelse
- Glukaner
- Heterocykliske forbindelser, bro-ring
- Atropinderivater
- Tropanes
- Azabicyclo -forbindelser
- Belladonna alkaloider
- Solanaceous alkaloider
- Bridged Bicyclo -forbindelser, heterocykliske
- Atropin
- Neostigmin
- Sugammadex
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- 25-AKD-309
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
IPD-planbeskrivelse
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
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