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Evaluation of Accelerometer-Based Neuromuscular Monitoring Reliability to Exclude Postoperative Residual Paralysis

20. april 2014 opdateret af: Federico Piccioni, MD, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano

Accelerometer-based neuromuscular monitoring is not the gold-standard method to evaluate residual postoperative paralysis but it represents the most simple, inexpensive and widespread tool in clinical practice. Train-of-four ratio (TOF-ratio) of 100% is considered the gold-standard to avoid PORC (post operative residual curarization).

This clinical trial is conducted to verify the reliability of accelerometer-based neuromuscular monitoring in order to exclude postoperative residual paralysis which is not highlighted by this instrument at a TOF-ratio=100%.

The study evaluates patients' neuromuscular recovery evaluated using pulmonary function tests after extubation at a TOFratio=100%. Administering placebo or sugammadex at a TOF ratio=100% allows to evaluate whether the recovery of muscle function is concrete, although the monitoring device shows a complete decurarization; patients treated with sugammadex should not be capable to perform better pulmonary function tests if a TOF ratio=100% is reliable.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

From the beginning of the surgery to the time of extubation neuromuscular block is monitored with accelerographic monitor TOF-Watch SX. Patients are extubated when TOF-ratio is 100%.

Patients will perform pulmonary function tests (PFTs):

  • the day ahead of surgery (for elegibility and training)
  • 60 minutes before surgery
  • 10 minutes after extubation
  • 5 minutes after sugammadex or placebo administration
  • 20 minutes after sugammadex or placebo administration.

The following parameters will be evaluated and compared between the 2 groups:

  • Maximal Inspiratory Pressure (MIP)
  • Maximal Expiratory Pressure (MEP)
  • Forced Expiratory Volume in the first Second (FEV1)
  • Forced Vital Capacity (FVC)
  • Ratio of Maximum Expiratory Flow and Maximum Inspiratory Flow rate at 50% of vital capacity (MEF50/MIF50)
  • PaO2, PaCO2, pH
  • heart rate, blood pressure and respiratory rate

Changes of pulmonary tests performed before and after sugammadex or placebo will be compared between study groups.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

20

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Italien
      • Milan, Italien
        • Fondazione IRCCS Istituto Nazionale dei Tumori

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år til 70 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • patients undergoing major abdominal surgery
  • age between 18 and 70 years
  • ASA class 1 or 2
  • patients scheduled for blended anesthesia (epidural + general anesthesia)
  • patients capable to perform pulmonary function tests (preoperative values of MIP, MEP, FEV1% and FEV1/FVC in normal ranges).

Exclusion Criteria:

  • known or suspected respiratory, cardiovascular or neuromuscular disease
  • renal or hepatic failure
  • known or suspected allergies to drugs used in the study
  • risk for malignant hyperthermia
  • pregnancy
  • diagnosed depressive disorder

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Tredobbelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: Sugammadex
Medicin: sugammadex
sugammadex 10 mg/ml diluted solution dosage: 1mg/kg i.v. (0,1 ml/kg)
Andre navne:
  • Bridion
Placebo komparator: Sodium chloride solution
Medicin: Sodium chloride solution
Sodium chloride solution 0,9% dosage: 0,1 ml/kg i.v.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Maximum Inspiratory Pressure (MIP) changes after placebo or sugammadex
Tidsramme: 10 minutes after surgery and 5 minutes later
10 minutes after surgery and 5 minutes later (after placebo or sugammadex administration)
10 minutes after surgery and 5 minutes later
Maximum Expiratory Pressure (MEP) changes after placebo or sugammadex
Tidsramme: 10 minutes after surgery and 5 minutes later
10 minutes after surgery and 5 minutes later (after placebo or sugammadex administration)
10 minutes after surgery and 5 minutes later
Forced Expiratory Volume after the first second (FEV1) changes after placebo or sugammadex
Tidsramme: 10 minutes after surgery and 5 minutes later
10 minutes after surgery and 5 minutes later (after placebo or sugammadex administration)
10 minutes after surgery and 5 minutes later
Forced Vital Capacity (FVC) changes after placebo or sugammadex
Tidsramme: 10 minutes after surgery and 5 minutes later
10 minutes after surgery and 5 minutes later (after placebo or sugammadex administration)
10 minutes after surgery and 5 minutes later

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Ratio of Maximum Expiratory Flow and Maximum Inspiratory Flow rate at 50% of vital capacity (MEF50/MIF50) changes after placebo or sugammadex
Tidsramme: 10 minutes after surgery and 5 minutes later
10 minutes after surgery and 5 minutes later (after placebo or sugammadex administration)
10 minutes after surgery and 5 minutes later
Hemogasanalysis parameters changes after placebo or sugammadex
Tidsramme: 10 minutes after surgery and 5 minutes later
10 minutes after surgery and 5 minutes later (after placebo or sugammadex administration)
10 minutes after surgery and 5 minutes later
Swallow ability changes after placebo or sugammadex
Tidsramme: 10 minutes after surgery and 5 minutes later
10 minutes after surgery and 5 minutes later (after placebo or sugammadex administration)
10 minutes after surgery and 5 minutes later

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Fondazione IRCCS Istituto Nazionale dei Tumori, Milano

Efterforskere

  • Studieleder: Federico Piccioni, MD, Fondazione IRCCS Istituto Nazionale dei tumori - Milan

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. december 2011

Primær færdiggørelse (Faktiske)

1. juni 2012

Studieafslutning (Faktiske)

1. juli 2012

Datoer for studieregistrering

Først indsendt

29. december 2011

Først indsendt, der opfyldte QC-kriterier

31. december 2011

Først opslået (Skøn)

4. januar 2012

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

22. april 2014

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

20. april 2014

Sidst verificeret

1. april 2014

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • INT-66/11

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

Kliniske forsøg med Postoperative Residual Paralysis

Kliniske forsøg med sugammadex

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