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Remifentanil im Vergleich zu Rocuronium zur Optimierung der Videolaryngoskopie-unterstützten Trachealintubation (ROCVIDEO)

16. September 2026 aktualisiert von: Nordsjaellands Hospital

Remifentanil im Vergleich zu Rocuronium zur Optimierung der Videolaryngoskopie-unterstützten Trachealintubation bei Patienten unter Vollnarkose – eine multizentrische randomisierte kontrollierte Studie – Die ROCVIDEO-Studie

Globally, we are approaching 1 million surgical procedures each day. Tracheal intubation is the mainstay of securing the patient's airway and breathing during general anaesthesia. Approximately 100.000 tracheal intubations are performed annually in Denmark. Airway management remains the primary reason for anaesthesia-related morbidity and mortality. It has been traditionally accepted that best tracheal intubation conditions are obtained by paralysing the patient's muscles, including vocal cords, using a neuromuscular blocking agent (NMBA) such as rocuronium. However, using NBMA may increase the risk of pulmonary complications, intra-operative awareness, in which the patient is paralysed but awake during surgery, anaphylaxis, and re-intubation. In addition, there is a risk of residual neuromuscular blockade postoperatively. In the US, prolonged ventilation and unplanned intubation are the top two most costly perioperative complications. An alternative to NMBA is a large dose of opioids to depress laryngeal reflexes during intubation. The most commonly used non-NMBA modality includes bolus administration of remifentanil. However, remifentanil may cause bradycardia and hypotension. Even short periods of hypotension have been shown to increase the risk of myocardial injury and other serious adverse events such as renal failure, delirium, and even mortality.

Evidence also indicates that intubation conditions using only opioids to facilitate intubation, including remifentanil, are inferior to NMBA. However, these trials are underpowered to assess effects on patient-important outcomes and are mostly at high risk of bias. A recent trial has suggested that remifentanil intubation conditions may not be very different. Almost all existing research comparing NMBA to opioids has focused on intubation conditions for direct laryngoscopy using a conventional Macintosh laryngoscopy blade. In recent years, the implementation and availability of the video laryngoscope have grown exponentially and become universal. The video laryngoscope has vastly improved the ease of tracheal intubation, and the number of failed intubations has decreased by two-thirds in Denmark, where a rapid implementation of the video laryngoscope took place. However, limited evidence exists on whether NMBA improves intubation conditions compared to remifentanil when performing video laryngoscope-assisted tracheal intubation.

Studienübersicht

Status

Rekrutierung

Bedingungen

Intervention / Behandlung

Studientyp

Interventionell

Einschreibung (Geschätzt)

2684

Phase

  • Phase 4

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienkontakt

Studieren Sie die Kontaktsicherung

Studienorte

      • Copenhagen, Dänemark, 2100
        • Rekrutierung
        • Department of Anesthesiology, NOH, Rigshospitalet
        • Kontakt:
      • Hillerød, Dänemark, 3400

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

18 Jahre und älter (Erwachsene, Älterer Erwachsener)

Akzeptiert gesunde Freiwillige

Nein

Studienberechtigte Geschlechter

Alle

Beschreibung

Inclusion Criteria:

  • Adults ≥ 18 years
  • Undergoing general anaesthesia requiring oro-tracheal intubation
  • Absence of indication for rapid sequence induction
  • American Society of Anesthesiologists (ASA) physical status score I - III

Exclusion Criteria:

  • Known allergies or contraindications to rocuronium (e.g. neuromuscular disease) or remifentanil
  • Awake intubation
  • Double-lumen endotracheal tube
  • Oral, pharyngeal, and laryngeal surgery
  • Surgical contraindication for NMBAs (e.g. use of nerve stimulator)
  • Patients who are pregnant or breastfeeding
  • Patients who do not understand Danish or are unable to give informed consent

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Behandlung
  • Zuteilung: Zufällig
  • Interventionsmodell: Parallele Zuordnung
  • Maskierung: Vervierfachen

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Experimental: REMI-arm

Bolus of remifentanil at anaesthesia induction

Age < 70 years: Bolus of 4 μg/kg Ideal Body Weight remifentanil at anaesthesia induction; Age >= 70 years: Bolus of 2 μg/kg ideal Body Weight remifentanil at anaesthesia induction

Andere Namen:
  • Remifentanil 5 mg verdünnt in 100 ml Kochsalzlösung, was Remifentanil 50 Mikrogramm/ml entspricht
Aktiver Komparator: ROCU-arm

Bolus of rocuronium at anaesthesia induction

Bolus of 0.6 mg/kg Ideal Body Weight rocuronium at anaesthesia induction

Andere Namen:
  • Rocuronium 10 mg/ml

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Proportion of participants with one or more intubation or anaesthesia related adverse events
Zeitfenster: 0 minutes to 24 hours after administration of drugs for intubation

Early (< 10 min): Cardiac arrest; anaphylaxis; pulmonary aspiration of gastric content; serious traumatic airway injury; desaturation (SAT < 90%); major hemodynamic instability (MAP < 50, new onset bradycardia < 40 beats/min); or sustained new arrhythmia (causing hemodynamic instability or requiring intervention).

Late (< 24 h): Death; brain damage including stroke; acute myocardial infarction; ICU admission; re-intubation; respiratory failure (oxygen demand > 5 l/min or requiring interventions aside from oxygen therapy); intraoperative awareness; pneumonia; dental injury; sore throat; or hoarseness.

0 minutes to 24 hours after administration of drugs for intubation
Proportion of participants with failed first-pass intubation
Zeitfenster: Tracheal intubation is performed 2 minutes after administration of rocuronium or remifentanil.

Defined as failed tracheal tube delivery after the first attempt of introduction of the video laryngoscope into the patient's mouth.

Tracheal tube delivery is defined as failed when the tube is retracted out of the patient's mouth, OR the video laryngoscope has to be retracted out of the patient's mouth, OR there is a shift in intubation equipment OR a change in the person performing the intubation management OR the intubation is abandoned.

Tracheal intubation is performed 2 minutes after administration of rocuronium or remifentanil.

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Patient satisfaction score
Zeitfenster: 24 hours after administration of drugs for intubation

The patient's experience of the treatment using a numeric rating scale (NRS 0 - 10 (0 = very dissatisfied; 10 = very satisfied))

24 hours after administration of drugs for intubation
Proportion of participants with one or more serious adverse events 0-7 days
Zeitfenster: 0 minutes to 7 days after administration of drugs for intubation

Defined as: respiratory failure, major adverse cardiac (in-hospital all-cause death, acute myocardial infarction (AMI) both acute ST elevation MI and non-ST elevation MI, complete heart block, cardiogenic shock, cardiac arrhythmia and cardiac arrest), pneumonia, acute kidney injury, admission to ICU and cerebrovascular event (ischemic stroke including transient cerebral ischemia).

0 minutes to 7 days after administration of drugs for intubation
Lengths of stay at the Post-Anaesthesia Care Unit.
Zeitfenster: 0-48 hours postoperatively

Minutes the patient is at the Post-Anaesthesia Care Unit.

0-48 hours postoperatively

Andere Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Proportion of participants with failed intubation
Zeitfenster: 2 to 20 minutes after administration of drugs for intubation

The intubation is abandoned

2 to 20 minutes after administration of drugs for intubation
Number of intubation attempts
Zeitfenster: 2 to 20 minutes after administration of drugs for intubation

The first attempt is defined as an attempt (successful or not) at tracheal tube delivery after the first introduction of the video laryngoscope into the patient's mouth.

Additionally attempts are defined as: when the tube has to be re-introduced into the patient's mouth, OR the videolaryngoscopy has to be re-introduced into the patient mouth, OR there is a shift in intubation equipment OR a change in the person performing the intubation management

2 to 20 minutes after administration of drugs for intubation
Vocal cords position at first intubation attempt
Zeitfenster: 2 to 20 minutes after administration of drugs for intubation

Categorised as closed, intermediate or open

2 to 20 minutes after administration of drugs for intubation
Proportion of participants with need for rescue medication or airway management
Zeitfenster: 2 to 20 minutes after administration of drugs for intubation

Rescue medication is defined as: An additional bolus of neuromuscular blocking agents, or bolus of opioid or propofol or other anesthetics according to the discretion of the attending anaesthesiologist in order to solve insufficient airway management conditions.

2 to 20 minutes after administration of drugs for intubation
Proportion of participants with anaesthesia induction related grave desaturation
Zeitfenster: 0 to 10 minutes after administration of drugs for intubation

SAT < 80%

0 to 10 minutes after administration of drugs for intubation
Proportion of participants in need of vasoactive or chronotropic substances after induction
Zeitfenster: 0 to 10 minutes after administration of drugs for intubation

Defined as any vasoactive substance, e.g. epinephrine, noradrenaline, phenylephrine, ephedrine administrated as a response to severe hypotension or bradycardia after induction.

0 to 10 minutes after administration of drugs for intubation
Individual components of the composite outcomes "Proportion of participants with one or more intubation or anaesthesia related adverse events" and "Proportion of participants with one or more serious adverse events 0-7 days"
Zeitfenster: 0 minutes to 7 days after administration of drugs for intubation

As stated in the relevant outcome descriptions

0 minutes to 7 days after administration of drugs for intubation

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

Ermittler

  • Hauptermittler: Anders K Nørskov, PhD, Department of Anaesthesia, Nordsjællands Hospital - Hillerød, Denmark
  • Hauptermittler: Matias Vested, PhD, Department of Anaesthesia Centre of Head and Orthopedics Rigshospitalet, University of Copenhagen

Publikationen und hilfreiche Links

Die Bereitstellung dieser Publikationen erfolgt freiwillig durch die für die Eingabe von Informationen über die Studie verantwortliche Person. Diese können sich auf alles beziehen, was mit dem Studium zu tun hat.

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Tatsächlich)

17. November 2025

Primärer Abschluss (Geschätzt)

1. April 2027

Studienabschluss (Geschätzt)

8. April 2027

Studienanmeldedaten

Zuerst eingereicht

25. Juni 2024

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

19. August 2024

Zuerst gepostet (Tatsächlich)

21. August 2024

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

21. September 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

16. September 2026

Zuletzt verifiziert

1. Oktober 2025

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Andere Studien-ID-Nummern

  • ROCVIDEO
  • 2025-521405-40-01 (Ctis)
  • 2025 (US NIH Stipendium/Vertrag)

Plan für individuelle Teilnehmerdaten (IPD)

Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?

JA

Beschreibung des IPD-Plans

Anonymised data will be made available upon reasonable request

IPD-Sharing-Zeitrahmen

The protocol is submitted prior to first randomisation. A comprehensive statistical analysis plan, including pre-specified subgroup analysis will be published before the final participant is enrolled.

Other material will be made available <12 months after trial cessation

IPD-Sharing-Zugriffskriterien

Anonymised data will be made available upon reasonable request.

Art der unterstützenden IPD-Freigabeinformationen

  • STUDIENPROTOKOLL
  • SAFT
  • ICF
  • ANALYTIC_CODE
  • CSR

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Nein

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

Diese Informationen wurden ohne Änderungen direkt von der Website clinicaltrials.gov abgerufen. Wenn Sie Ihre Studiendaten ändern, entfernen oder aktualisieren möchten, wenden Sie sich bitte an register@clinicaltrials.gov. Sobald eine Änderung auf clinicaltrials.gov implementiert wird, wird diese automatisch auch auf unserer Website aktualisiert .