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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
Studie Overzicht
Toestand
Interventie / Behandeling
Gedetailleerde beschrijving
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.
Studietype
Inschrijving (Geschat)
Fase
- Fase 4
Contacten en locaties
Studiecontact
- Naam: Ersel Gulec, MD
- Telefoonnummer: 3289 +903223386060
- E-mail: gulecersel@yahoo.com
Studie Locaties
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Adana, Turkije (Türkiye)
- Werving
- Cukurova University Faculty of Medicine
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Hoofdonderzoeker:
- Ersel Gulec, MD
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Onderonderzoeker:
- Mediha Turktan, MD
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Onderonderzoeker:
- Zehra Hatipoglu, MD
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Onderonderzoeker:
- Dilek Ozcengiz, MD
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Contact:
- Ersel Gulec, MD
- Telefoonnummer: 3289 +903223386060
- E-mail: gulecersel@yahoo.com
-
Onderonderzoeker:
- Kubra Gunsur, MD
-
Onderonderzoeker:
- Demet Lafli Tunay, MD
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-
Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Beschrijving
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.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Dubbele
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
|
Actieve vergelijker: Group S
Sugammadex, intravenous, 2 mg/kg, single bolus dose.
|
Intravenous bolus injection
|
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Actieve vergelijker: Group N
Neostigmine, intravenous, 0.05 mg/kg, single bolus dose.
Atropine sulfate, intravenous, 0.02 mg/kg, single bolus dose.
|
Intravenous bolus injection
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Change in average optic nerve sheath diameter from intubation to the 5th minute after extubation
Tijdsspanne: 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
|
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Blood Pressure
Tijdsspanne: 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
|
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Postoperative nausea and vomiting
Tijdsspanne: 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
Tijdsspanne: 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.
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Medewerkers en onderzoekers
Sponsor
Onderzoekers
- Hoofdonderzoeker: Ersel Gulec, MD, Cukurova University
Publicaties en nuttige links
Algemene publicaties
- 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.
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Primaire voltooiing (Geschat)
Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
- Organische chemicaliën
- Heterocyclische verbindingen
- Koolhydraten
- Alkaloïden
- Polycyclische verbindingen
- Amines
- Aza -verbindingen
- Polysachariden
- Macrocyclische verbindingen
- Fenylammoniumverbindingen
- Quaternaire ammoniumverbindingen
- Oniumverbindingen
- gamma-cyclodextrins
- Cyclodextrins
- Dextrins
- Zetmeel
- Glucanen
- Heterocyclische verbindingen, overbrugde ring
- Atropine -derivaten
- Tropanes
- Azabicyclo -verbindingen
- Belladonna alkaloïden
- Solanaceous alkaloïden
- Brugged Bicyclo -verbindingen, heterocyclisch
- Atropine
- Neostigmine
- Sugammadex
Andere studie-ID-nummers
- 25-AKD-309
Plan Individuele Deelnemersgegevens (IPD)
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Beschrijving IPD-plan
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Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
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