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The Effect of Neostigmine and Sugammadex on the Optic Nerve Sheath Diameter

2026年6月19日 更新者：Ersel GULEC、Cukurova University

Comparison of the Effects of Neostigmine and Sugammadex on the Optic Nerve Sheath Diameter During the Postoperative Extubation Period

This study will compare how two drugs, sugammadex and neostigmine-used to reverse muscle relaxation after surgery-affect the size of the optic nerve sheath (the nerve behind the eye) as patients wake up and have their breathing tubes removed. It will also examine the relationship between changes in blood pressure and heart rate during this time and these measurements. This study will be conducted on 86 healthy patients aged 18-65 who will undergo planned surgery at the Çukurova University Faculty of Medicine, Department of Anesthesiology and Reanimation. Patients will be randomly divided into two groups: the sugammadex group and the neostigmine group. All patients will receive standard general anesthesia and rocuronium to relax their muscles. At the end of the surgery, to reverse this effect, patients will be given either sugammadex or a mix of neostigmine and atropine. Group S will receive 2 mg sugammadex per kg, while Group N will receive 0.05 mg neostigmine and 0.02 mg atropine per kg. The width of the optic nerve sheath will be measured by ultrasound 5 minutes after the breathing tube is inserted, 5 minutes before the tube is removed, and 5 minutes after it is removed. Additionally, blood pressure, heart rate, and any complications during the surgery will be tracked and compared between the groups.

研究概览

地位

招聘中

条件

干预/治疗

详细说明

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.

研究类型

介入性

注册 (估计的)

86

阶段

  • 第四阶段

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。

学习联系方式

学习地点

  • 土耳其（türkiye）
      • Adana、土耳其（türkiye）
        • 招聘中
        • Cukurova University Faculty of Medicine
        • 首席研究员：
          • Ersel Gulec, MD
        • 副研究员：
          • Mediha Turktan, MD
        • 副研究员：
          • Zehra Hatipoglu, MD
        • 副研究员：
          • Dilek Ozcengiz, MD
        • 接触：
        • 副研究员：
          • Kubra Gunsur, MD
        • 副研究员：
          • Demet Lafli Tunay, MD

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

  • 成人
  • 年长者

接受健康志愿者

不

描述

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.

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：治疗
  • 分配：随机化
  • 介入模型：并行分配
  • 屏蔽：双倍的

武器和干预

参与者组/臂
干预/治疗
有源比较器：Group S
Sugammadex, intravenous, 2 mg/kg, single bolus dose.
药品：Sugammadex 2 mg/kg
Intravenous bolus injection
有源比较器：Group N
Neostigmine, intravenous, 0.05 mg/kg, single bolus dose. Atropine sulfate, intravenous, 0.02 mg/kg, single bolus dose.
药品：Neostigmine + Atropine
Intravenous bolus injection

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
Change in average optic nerve sheath diameter from intubation to the 5th minute after extubation
大体时间：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

次要结果测量

结果测量
措施说明
大体时间
Blood Pressure
大体时间：From the time of endotracheal intubation until 5 minutes after extubation
Blood pressure will be measured and recorded 5 minutes after endotracheal intubation, 5 minutes before extubation, and 5 minutes after extubation
From the time of endotracheal intubation until 5 minutes after extubation
Postoperative nausea and vomiting
大体时间：The one-hour period from endotracheal tube removal to patient discharge from the postoperative care unit.
The number of patients who experienced nausea and vomiting upon waking from anesthesia and during their stay in the postoperative care unit.
The one-hour period from endotracheal tube removal to patient discharge from the postoperative care unit.
Blood pressure
大体时间：The one-hour period from endotracheal tube removal to patient discharge from the postoperative care unit.
Noninvasive measurement of blood pressure
The one-hour period from endotracheal tube removal to patient discharge from the postoperative care unit.

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。

赞助

Cukurova University

调查人员

  • 首席研究员：Ersel Gulec, MD、Cukurova University

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

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 (实际的)

2026年6月4日

初级完成 (估计的)

2026年7月10日

研究完成 (估计的)

2026年7月10日

研究注册日期

首次提交

2026年6月8日

首先提交符合 QC 标准的

2026年6月19日

首次发布 (实际的)

2026年6月24日

研究记录更新

最后更新发布 (实际的)

2026年6月24日

上次提交的符合 QC 标准的更新

2026年6月19日

最后验证

2026年6月1日

更多信息

与本研究相关的术语

关键字

其他相关的 MeSH 术语

其他研究编号

  • 25-AKD-309

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

All collected IPD may be shared with relevant parties upon request, with the principal investigator's approval, provided that no personally identifiable information or hospital records are disclosed.

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

此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.

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