Muscle Relax Affects Outcomes of Robotic Surgery
- Conditions
- Postoperative ComplicationsGeneral Anesthesia
- Interventions
- Registration Number
- NCT03726372
- Lead Sponsor
- Air Force Military Medical University, China
- Brief Summary
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.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 192
- 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
- Patients allergic to rocuronium
- Patients with neuromuscular dysfunction
- Patients with existed pulmonary diseases
- Patients with hepatic or renal dysfunction
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description deep neuromuscular blockade Rocuronium 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 deep neuromuscular blockade continuous infusion 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 moderate neuromuscular blockade Rocuronium 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 moderate neuromuscular blockade intermittent injection 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
- Primary Outcome Measures
Name Time Method incidence of postoperative major respiratory complications from end of surgery to discharge, at an average of 4 days incidence of pneumonia and atelectasis
- Secondary Outcome Measures
Name Time Method satisfaction score of the patients 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.
number of surgeon asking for improving muscle relax 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
incidence of shoulder pain in 24 hours after surgery from end of surgery to 24 hours after surgery time to extubation 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
incidence of nausea and vomiting in post-anesthesia care unit from admittance to post-anesthesia care unit(PACU) to discharge from PACU, at an average of 30 minutes incidence of residual neuromuscular blockade in the post-anesthesia care unit 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
maximal airway pressure 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
minimal cerebral oxygen saturation from start of surgery to end of surgery, at an average of 3.5 hours cerebral oxygen saturation is continuously monitored during surgery
maximal intraocular pressure from start of surgery to end of surgery, at an average of 3.5 hours intraocular pressure is monitored every 10 minutes during surgery
visual analogue scale at 24 hours after surgery 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
expense after surgery end of the surgery to discharge,at an average of 4 days the expense from immediately after surgery to discharge