Rocuronium vs Cis-atracurium: Do Rocuronium Still 'ROCKS' In Coronary Artery Bypass Grafting

Completed

• Conditions: Neuromuscular Blockade; Postoperative Pulmonary Atelectasis; Postoperative Pulmonary Complication; Coronary Artery Disease; Coronary Artery Bypass Grafting; Hypothermic Cardiopulmonary Bypass
• Interventions: Drug: Rocuronium Bromide 10 MG/ML; Drug: Nimbex 10 MG in 5 ML Injection

• Registration Number: NCT06102915
• Lead Sponsor: Institut Jantung Negara

Brief Summary

The current trend in most cardiac surgeries was to use rocuronium as it provides faster recovery in train-of-four ratio compared to other aminosteroid non-depolarising neuromuscular blocker. However, as most cardiac centres' standard of care does not perform any neuromuscular monitoring nor antagonism of neuromuscular blockade effect, residual neuromuscular blockade could potentially be the key to delayed extubation. As such, Cis-atracurium's organ-independent Hofmann elimination could be in favour.

Detailed Description

Not available

Study Timeline

• Study Start: 2023-08-01
• Study First Submitted: 2023-10-22
• Study First Submitted QC: 2023-10-22
• Study First Posted: 2023-10-26
• Status Verified: 2023-11
• Last Update Submitted: 2023-11-22
• Primary Completion: 2023-11-23
• Study Completion: 2023-11-23
• Last Update Posted: 2023-11-28

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 289

Inclusion Criteria

• All patients that undergo general anaesthesia for CABG surgery requiring neuromuscular blockade of either rocuronium or cis-atracurium

Exclusion Criteria

1. Recent history of pulmonary infection four weeks before surgery
2. Exposed to both neuromuscular blockade within 24 hours perioperatively
3. Patients intubated or on tracheostomies pre-operatively
4. Any missing or incomplete data

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Rocuronium	Rocuronium Bromide 10 MG/ML	Rocuronium 1mg/kg to be given at induction of anaesthesia and another 1mg/kg would be given when the patient is on hypothermic cardiopulmonary bypass
Cis-atracurium	Nimbex 10 MG in 5 ML Injection	Cis-atracurium 0.2mg/kg to be given at induction of anaesthesia and another 0.2mg/kg would be given when the patient is on hypothermic cardiopulmonary bypass

Primary Outcome Measures

Name	Time	Method
Incidence of postoperative pulmonary complication	6 months	Which neuromuscular relaxant is associated with lesser postoperative pulmonary complication

Secondary Outcome Measures

Name	Time	Method
Ventilation hours in ICU	6 months	Ventilation hours from ICU admission from OR to extubation
Requirements for Non-invasive ventilation	6 months	NIV duration
Incidence of postoperative atrial fibrillation	6 months	Incidence of postoperative atrial fibrillation

Trial Locations

Locations (1)

Institut Jantung Negara; 🇲🇾 Kuala Lumpur, Malaysia