Development of an Algorithm Using Clinical Tests to Avoid Post-operative Residual Neuromuscular Block
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Postoperative Residual Curarization
- Sponsor
- University of Regensburg
- Enrollment
- 265
- Locations
- 5
- Primary Endpoint
- Clinical muscle function tests
- Status
- Completed
- Last Updated
- 8 years ago
Overview
Brief Summary
Objective neuromuscular monitoring is the gold standard to detect postoperative residual curarization (PORC). Many anesthesiologist just use qualitative neuromuscular monitoring or unreliable, clinical tests. Goal of this study is to develop an algorithm of muscle function tests to identify PORC
Detailed Description
Background: Quantitative neuromuscular monitoring is the gold standard to detect postoperative residual curarization (PORC). Many anesthesiologists, however, use insensitive, qualitative neuromuscular monitoring or unreliable, clinical tests. Goal of this multicentre, prospective, double-blinded, assessor controlled study is to develop an algorithm of muscle function tests to identify PORC. Methods: After extubation a blinded anesthetist performs eight clinical tests in 165 patients. Test results are correlated to calibrated electromyography train-of-four (TOF) ratio and to a postoperatively applied uncalibrated acceleromyography. A classification and regression tree (CART) is calculated developing the algorithm to identify PORC. This is validated against uncalibrated acceleromyography and tactile judgement of TOF fading in separate 100 patients.
Investigators
Christoph Unterbuchner
Principal Investigator
University of Regensburg
Eligibility Criteria
Inclusion Criteria
- •The patients were scheduled for elective low risk surgical procedures:
- •laparoscopic abdominal procedures
- •orthopedic
- •minor visceral surgery
Exclusion Criteria
- •participation in another study
- •body mass index over 30
- •history of neuromuscular diseases
- •gastro-esophageal reflux disease.
Outcomes
Primary Outcomes
Clinical muscle function tests
Time Frame: Muscle function tests are performed immediately after extubation.
Measurement of postoperative residual curarisation with clinical muscle function test: * time able to open the eyes * appearence of diplopic images * time able to stick out the tongue * spatula pressure test * time able to lift the head * time able to lift the arm * strength of the patient pressing the investigator's hand * ability to swallow 20 ml of water
Secondary Outcomes
- Uncalibrated acceleromyography(Uncalibrated acceleromyography is measured immediately after extubation.)
- Qualitative neuromuscular measurement(Qualitative acceleromyography is measured immediately after extubation.)