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Evaluation of Accelerometer-Based Neuromuscular Monitoring Reliability to Exclude Postoperative Residual Paralysis
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.
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
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.
Studietype
Inschrijving (Werkelijk)
Fase
- Niet toepasbaar
Contacten en locaties
Studie Locaties
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Milan, Italië
- Fondazione IRCCS Istituto Nazionale dei Tumori
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
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
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Verdrievoudigen
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
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Actieve vergelijker: Sugammadex
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sugammadex 10 mg/ml diluted solution dosage: 1mg/kg i.v.
(0,1 ml/kg)
Andere namen:
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Placebo-vergelijker: Sodium chloride solution
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Sodium chloride solution 0,9% dosage: 0,1 ml/kg i.v.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Maximum Inspiratory Pressure (MIP) changes after placebo or sugammadex
Tijdsspanne: 10 minutes after surgery and 5 minutes later
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10 minutes after surgery and 5 minutes later (after placebo or sugammadex administration)
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10 minutes after surgery and 5 minutes later
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Maximum Expiratory Pressure (MEP) changes after placebo or sugammadex
Tijdsspanne: 10 minutes after surgery and 5 minutes later
|
10 minutes after surgery and 5 minutes later (after placebo or sugammadex administration)
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10 minutes after surgery and 5 minutes later
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Forced Expiratory Volume after the first second (FEV1) changes after placebo or sugammadex
Tijdsspanne: 10 minutes after surgery and 5 minutes later
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10 minutes after surgery and 5 minutes later (after placebo or sugammadex administration)
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10 minutes after surgery and 5 minutes later
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Forced Vital Capacity (FVC) changes after placebo or sugammadex
Tijdsspanne: 10 minutes after surgery and 5 minutes later
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10 minutes after surgery and 5 minutes later (after placebo or sugammadex administration)
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10 minutes after surgery and 5 minutes later
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Ratio of Maximum Expiratory Flow and Maximum Inspiratory Flow rate at 50% of vital capacity (MEF50/MIF50) changes after placebo or sugammadex
Tijdsspanne: 10 minutes after surgery and 5 minutes later
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10 minutes after surgery and 5 minutes later (after placebo or sugammadex administration)
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10 minutes after surgery and 5 minutes later
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Hemogasanalysis parameters changes after placebo or sugammadex
Tijdsspanne: 10 minutes after surgery and 5 minutes later
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10 minutes after surgery and 5 minutes later (after placebo or sugammadex administration)
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10 minutes after surgery and 5 minutes later
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Swallow ability changes after placebo or sugammadex
Tijdsspanne: 10 minutes after surgery and 5 minutes later
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10 minutes after surgery and 5 minutes later (after placebo or sugammadex administration)
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10 minutes after surgery and 5 minutes later
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Medewerkers en onderzoekers
Onderzoekers
- Studie directeur: Federico Piccioni, MD, Fondazione IRCCS Istituto Nazionale dei tumori - Milan
Publicaties en nuttige links
Studie record data
Bestudeer belangrijke data
Studie start
Primaire voltooiing (Werkelijk)
Studie voltooiing (Werkelijk)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Schatting)
Updates van studierecords
Laatste update geplaatst (Schatting)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- INT-66/11
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