Muscle Relax Affects Outcomes of Robotic Surgery (MORE)
29. oktober 2018 oppdatert av: Zhihong LU, Air Force Military Medical University, China
Effect of Neuromuscular Blockade Protocol on Perioperative Outcomes of Robotic Laparoscopic Surgery
During robotic laparoscopic surgery, a high intraperitoneal pressure may result in high airway pressure and inadequate perfusion of the abdominal organs, and as a result the postoperative outcomes.
Degree of neuromuscular blockade (NMB) can affect the intraperitoneal pressure.
In this study, the patients undergoing robotic laparoscopic surgery will be assigned to deep NMB group and moderate NMB group.
Perioperative outcomes including maximal intraperitoneal pressure, maximal intraoptic pressure, quality of emergence, postoperative pain, and incidence of postoperative respiratory complication will be compared.
The results of this study will provide evidence for optimizing NMB protocol of robotic laparoscopic surgery.
Studieoversikt
Status
Ukjent
Intervensjon / Behandling
Studietype
Intervensjonell
Registrering (Forventet)
192
Fase
- Ikke aktuelt
Kontakter og plasseringer
Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.
Deltakelseskriterier
Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
18 år til 80 år (Voksen, Eldre voksen)
Tar imot friske frivillige
Nei
Kjønn som er kvalifisert for studier
Alle
Beskrivelse
Inclusion Criteria:
- patients scheduled for elective robotic laparoscopic surgery under general anesthesia
- American Society of Anesthesiologists status 1-2
- Body mass index of 18-30kg/m2
- Patients scheduled to be positioned in trendelenburg position during surgery
Exclusion Criteria:
- Patients allergic to rocuronium
- Patients with neuromuscular dysfunction
- Patients with existed pulmonary diseases
- Patients with hepatic or renal dysfunction
Studieplan
Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Forebygging
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Trippel
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
|
Eksperimentell: deep neuromuscular blockade
Rocuronium, a neuromuscular blocking agent will be given by continuous infusion at a dose that reaction to train of four (TOF) stimulation is depressed to zero
|
rocuronium is a neuromuscular blocking agent with a duration of 40 minutes
Andre navn:
rocuronium is continuously infused
Andre navn:
|
|
Eksperimentell: moderate neuromuscular blockade
Rocuronium, a neuromuscular blocking agent will be given at a dose by intermittent injection that reaction to train of four (TOF) stimulation is kept 1 to 2
|
rocuronium is a neuromuscular blocking agent with a duration of 40 minutes
Andre navn:
rocuronium is intermittently given
Andre navn:
|
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
incidence of postoperative major respiratory complications
Tidsramme: from end of surgery to discharge, at an average of 4 days
|
incidence of pneumonia and atelectasis
|
from end of surgery to discharge, at an average of 4 days
|
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
maximal airway pressure
Tidsramme: from establishment of pneumoperitoneum to end of pneumoperitoneum, at an average of 3 hours
|
airway pressure is titrated to as low as possible as long as the end tidal carbon dioxide partial pressure is lower than 40 mmHg
|
from establishment of pneumoperitoneum to end of pneumoperitoneum, at an average of 3 hours
|
|
minimal cerebral oxygen saturation
Tidsramme: from start of surgery to end of surgery, at an average of 3.5 hours
|
cerebral oxygen saturation is continuously monitored during surgery
|
from start of surgery to end of surgery, at an average of 3.5 hours
|
|
maximal intraocular pressure
Tidsramme: from start of surgery to end of surgery, at an average of 3.5 hours
|
intraocular pressure is monitored every 10 minutes during surgery
|
from start of surgery to end of surgery, at an average of 3.5 hours
|
|
number of surgeon asking for improving muscle relax
Tidsramme: from start of surgery to end of surgery, at an average of 3.5 hours
|
when the surgeon is unsatisfied with the muscle relax, he can tell the anesthetist
|
from start of surgery to end of surgery, at an average of 3.5 hours
|
|
time to extubation
Tidsramme: from end of sevoflurane inhalation to extubation, at an average of 20 minutes
|
criteria of extubation: spontaneous respiratory rate>10 per minute and end tidal carbon dioxide partial pressure<45mmHg
|
from end of sevoflurane inhalation to extubation, at an average of 20 minutes
|
|
incidence of nausea and vomiting in post-anesthesia care unit
Tidsramme: from admittance to post-anesthesia care unit(PACU) to discharge from PACU, at an average of 30 minutes
|
from admittance to post-anesthesia care unit(PACU) to discharge from PACU, at an average of 30 minutes
|
|
|
incidence of shoulder pain in 24 hours after surgery
Tidsramme: from end of surgery to 24 hours after surgery
|
from end of surgery to 24 hours after surgery
|
|
|
incidence of residual neuromuscular blockade in the post-anesthesia care unit
Tidsramme: from admittance to post-anesthesia care unit(PACU) to discharge from PACU, at an average of 30 minutes
|
residual neuromuscular blockade is defined as time of head-lift or limb-lift<10 seconds
|
from admittance to post-anesthesia care unit(PACU) to discharge from PACU, at an average of 30 minutes
|
|
visual analogue scale at 24 hours after surgery
Tidsramme: end of surgery to 24 hours after surgery
|
the patients are asked to mark the score they feel, 0 is no pain,100 is untolerated pain
|
end of surgery to 24 hours after surgery
|
|
expense after surgery
Tidsramme: end of the surgery to discharge,at an average of 4 days
|
the expense from immediately after surgery to discharge
|
end of the surgery to discharge,at an average of 4 days
|
|
satisfaction score of the patients
Tidsramme: from end of surgery to discharge,at an average of 4 days
|
the patient is asked to give a score between 0 and 10, 0 means not satisfied,10 means totally satisfied.
|
from end of surgery to discharge,at an average of 4 days
|
Samarbeidspartnere og etterforskere
Det er her du vil finne personer og organisasjoner som er involvert i denne studien.
Etterforskere
- Hovedetterforsker: Zhihong Lu, Xijing Hospital
Publikasjoner og nyttige lenker
Den som er ansvarlig for å legge inn informasjon om studien leverer frivillig disse publikasjonene. Disse kan handle om alt relatert til studiet.
Generelle publikasjoner
- Martini CH, Boon M, Bevers RF, Aarts LP, Dahan A. Evaluation of surgical conditions during laparoscopic surgery in patients with moderate vs deep neuromuscular block. Br J Anaesth. 2014 Mar;112(3):498-505. doi: 10.1093/bja/aet377. Epub 2013 Nov 15.
- Van Wijk RM, Watts RW, Ledowski T, Trochsler M, Moran JL, Arenas GW. Deep neuromuscular block reduces intra-abdominal pressure requirements during laparoscopic cholecystectomy: a prospective observational study. Acta Anaesthesiol Scand. 2015 Apr;59(4):434-40. doi: 10.1111/aas.12491. Epub 2015 Feb 13.
- Torensma B, Martini CH, Boon M, Olofsen E, In 't Veld B, Liem RS, Knook MT, Swank DJ, Dahan A. Deep Neuromuscular Block Improves Surgical Conditions during Bariatric Surgery and Reduces Postoperative Pain: A Randomized Double Blind Controlled Trial. PLoS One. 2016 Dec 9;11(12):e0167907. doi: 10.1371/journal.pone.0167907. eCollection 2016.
- Barrio J, Errando CL, Garcia-Ramon J, Selles R, San Miguel G, Gallego J. Influence of depth of neuromuscular blockade on surgical conditions during low-pressure pneumoperitoneum laparoscopic cholecystectomy: A randomized blinded study. J Clin Anesth. 2017 Nov;42:26-30. doi: 10.1016/j.jclinane.2017.08.005. Epub 2017 Aug 30.
Studierekorddatoer
Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.
Studer hoveddatoer
Studiestart (Forventet)
10. november 2018
Primær fullføring (Forventet)
10. november 2019
Studiet fullført (Forventet)
10. november 2019
Datoer for studieregistrering
Først innsendt
28. oktober 2018
Først innsendt som oppfylte QC-kriteriene
29. oktober 2018
Først lagt ut (Faktiske)
31. oktober 2018
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
31. oktober 2018
Siste oppdatering sendt inn som oppfylte QC-kriteriene
29. oktober 2018
Sist bekreftet
1. oktober 2018
Mer informasjon
Begreper knyttet til denne studien
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
- XJH-A-20180701
Plan for individuelle deltakerdata (IPD)
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IPD-planbeskrivelse
After publishing, data of the primary endpoint and second endpoints can be shared with other researchers
IPD-delingstidsramme
When the results have been published in peer-reviewed journals, the data will be available.
The planned time frame will be 5 years.
IPD-deling Støtteinformasjonstype
- STUDY_PROTOCOL
- SEVJE
- ICF
- CSR
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