Recovery From dNMB Using Different Sugammadex Doses in Elderly Patients Undergoing Robot-assisted Prostatectomy
- Conditions
- Neuromuscular BlockadeProstate Cancer
- Interventions
- Registration Number
- NCT04854993
- Brief Summary
The aim of this prospecive randomized study is to evaluate the effects of a dose of sugammadex increased by 50% compared to a standard dose on recovery time from deep neuromuscular block in elderly patients undergoing robot-assisted laparoscopic radical prostatectomy (RALP). Secondary objectives are to evaluate the different extubation time, time to exit from the operating room (OR), lenght of stay in post-anaesthesia care unit (PACU) and safety (hemodynamic parameters and respiratory function).
- Detailed Description
An increasing percentage of elderly patients with localized prostate cancer undergo RALP, due to the higher safety and feasibility of this minimally invasive surgical option compared to standard open procedure. This procedure is performed under deep neuromuscular block (dNMB) in order to guarantee an adequate working space. Induction and maintenance of the dNMB require neuromuscular monitoring and adequate reversal at the end of the intervention to prevent postoperative residual curarization (PORC). Sugammadex is the most attractive strategy to titrate reversal according to NMB monitoring data and to ensure a complete recovery of muscle function before extubation. In elderly patients, the risk of PORC and related postoperative complications is higher. For these reasons, we hypothesize that a dose of sugammadex increased by 50% compared to a standard dose could significantly shorten neuromuscular recovery time, extubation time, OR discharge time and PACU length of stay in elderly patients undergoing RALP.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- Male
- Target Recruitment
- 34
- patient's age ≥65years
- prostate cancer
- robot-assisted laparoscopic radical prostatectomy (RALP)
- inability to obtain written informed consent
- history of significant liver, renal or pulmonary diseases
- current smoking
- chronic or acute alcoholism
- known or suspected neuromuscular disorders
- family history of malignant hyperthermia
- any pre-existing coagulopathy
- abnormal blood coagulation tests (including prothrombin time <70%; activated partial thromboplastin time >38 seconds and INR >1.20) or preoperative anticoagulant therapies
- BMI ≥30 Kg/m2
- known allergy or hypersensitivity to the drugs used in the study
- planned postoperative admission to intensive care unit.
- moderate neuromuscular block (TOF 1-3) at the end of surgery
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Standard dose of sugammadex Sugammadex 4 mg/kg A dose of 6 mg/kg of sugammadex will be given intravenously for deep neuromuscular block reversal at the end of surgery Increased dose of sugammadex Sugammadex 6 mg/kg A dose of 6 mg/kg of sugammadex will be given intravenously for deep neuromuscular block reversal at the end of surgery
- Primary Outcome Measures
Name Time Method Neuromuscular recovery time 5 minutes Time from the end of sugammadex administration to train-of-four (TOF)=1
- Secondary Outcome Measures
Name Time Method Hemodynamic parameters up to discharge from post-anaesthesia care unit, an average of 2 hours Non-invasive blood pressure (mmHg) and heart rate (beats per minute) after sugammadex administration
Respiratory function up to discarge from post-anaesthesia care unit, an average of 2 hours Peripheral oxygen saturation (percentage) and respiratory rate (breaths per minute) after sugammadex administration
Time to extubation 10 minutes Time from neuromuscular reversal (TOF=1) to extubation
PACU length of stay 2 hours Duration of stay in the post-anaesthesia care unit
Time to OR exit 30 minutes Time from neuromuscular reversal (TOF=1) to exit from the operating room
Trial Locations
- Locations (1)
Fondazione Policlinico Universitario A. Gemelli IRCCS
🇮🇹Rome, Italy