Muscle Relax Affects Outcomes of Robotic Surgery (MORE)
2018年10月29日 更新者：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.
研究概览
研究类型
介入性
注册 (预期的)
192
阶段
- 不适用
联系人和位置
本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。
参与标准
研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
18年 至 80年 (成人、年长者)
接受健康志愿者
不
有资格学习的性别
全部
描述
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
学习计划
本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。
研究是如何设计的？
设计细节
- 主要用途：预防
- 分配：随机化
- 介入模型：并行分配
- 屏蔽：三倍
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
实验性的：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
其他名称：
rocuronium is continuously infused
其他名称：
|
|
实验性的：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
其他名称：
rocuronium is intermittently given
其他名称：
|
研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
incidence of postoperative major respiratory complications
大体时间：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
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
maximal airway pressure
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
|
合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
调查人员
- 首席研究员：Zhihong Lu、Xijing Hospital
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
一般刊物
- 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.
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始 (预期的)
2018年11月10日
初级完成 (预期的)
2019年11月10日
研究完成 (预期的)
2019年11月10日
研究注册日期
首次提交
2018年10月28日
首先提交符合 QC 标准的
2018年10月29日
首次发布 (实际的)
2018年10月31日
研究记录更新
最后更新发布 (实际的)
2018年10月31日
上次提交的符合 QC 标准的更新
2018年10月29日
最后验证
2018年10月1日
更多信息
与本研究相关的术语
其他研究编号
- XJH-A-20180701
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)？
是的
IPD 计划说明
After publishing, data of the primary endpoint and second endpoints can be shared with other researchers
IPD 共享时间框架
When the results have been published in peer-reviewed journals, the data will be available.
The planned time frame will be 5 years.
IPD 共享支持信息类型
- 研究方案
- 树液
- 国际碳纤维联合会
- 企业社会责任
药物和器械信息、研究文件
研究美国 FDA 监管的药品
不
研究美国 FDA 监管的设备产品
不
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