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临床试验/NCT03210376
NCT03210376已完成4 期

The Effect of Deep Neuromuscular Blockade With Sugammadex Reversal on Shoulder Pain of Elderly Patients Undergoing Robotic Surgery: A Single-Center Double-Blinded Randomized Controlled Trial

M.D. Anderson Cancer Center1 个研究点 分布在 1 个国家目标入组 100 人开始时间: 2017年11月17日最近更新:
适应症
干预措施
相关药物

试验速览

阶段
4 期
状态
已完成
入组人数
100
试验地点
1
主要终点
Percentage of Patients Who Reported Shoulder Pain

研究概览

简要总结

Insufflation pressure (IP) is the creation of a pressure barrier of air/gas within the abdomen to allow the surgeon more space to work during abdominal surgery. Shoulder pain is a common complaint from patients who have had abdominal surgery and the pain is thought to be related to the use of IP.

In addition to anesthesia (which keeps you asleep during surgery), the current standard practice is to block the nerve-muscle junction with a type of drug called neuromuscular blockade (NMB) which paralyzes the abdominal muscles. This means that a lower level of insufflation pressure is needed by the surgeon.

To reverse the effects of NMB after surgery, a drug called neostigmine is given.

The goal of this clinical research study is to compare the use of standard-of-care moderate NMB and neostigmine to the use of deep NMB and a drug called Sugammadex when given to elderly patients (patients who are 65 years of age or older) who are scheduled to have robotic abdominal surgery. "Deep" and "moderate" in this study refers to the dose or strength of the NMB given.

This is an investigational study. Sugammadex and neostigmine are FDA approved and commercially available for the reversal of NMB. It is considered investigational to compare Sugammadex and neostigmine to learn if the use of one or the other in elderly patients can reduce the level of shoulder pain after surgery.

Up to 100 participants will be enrolled in this study. All will take part at MD Anderson.

详细描述

Study Groups:

If you are found to be eligible to take part in this study, you will be randomly assigned (as in the flip of a coin) to 1 of 2 study groups before your surgery. This is done because no one knows if one group is better, the same, or worse than the other.

  • In Group 1, you will receive deep NMB and Sugammadex.
  • In Group 2, you will receive moderate NMB and neostigmine.

Neither you nor the surgeon or surgical staff will know to which group you have been assigned. The surgeon will not know which group you are in because researchers want to learn how much, if at all, the surgeon needs to adjust the insufflation pressure during surgery. However, if needed for your safety, the surgeon will be able to find out which group you are in.

For your safety, the anesthesiologist will know to which group you have been assigned.

研究设计

研究类型
Interventional
分配方式
Randomized
干预模型
Parallel
主要目的
Treatment
盲法
Double (Participant, Investigator)

入排标准

年龄范围
65 Years 至 —(Older Adult)
性别
All
接受健康志愿者

入选标准

  • Patients 65 years of age or older
  • Patients having robotic prostatectomy
  • Written informed consent

排除标准

  • Patient with known hypersensitivity to Rocuronium, Sugammadex or its components
  • Patients with severe renal insufficiency, defined and confirmed by an estimated creatinine clearance equal or lower than 30 mL/min, per institutional laboratory.
  • Patients with history of severe liver disease, defined as and confirmed by elevated ALT and AST greater than 1.5 times the Upper Limit of Normal along with Albumin less than 3 OR INR 1.5 or greater per institutional laboratory.

研究组 & 干预措施

Deep Neuromuscular Blockade (NMB) + Sugammadex

Experimental

Deep Neuromuscular Blockade (NMB) given during surgery.

Sugammadex intravenously as a single bolus injection after surgery.

Pain assessment done at about 15, 45, and 90 minutes after surgery.

干预措施: Deep Neuromuscular Blockade (NMB) (Drug)

Deep Neuromuscular Blockade (NMB) + Sugammadex

Experimental

Deep Neuromuscular Blockade (NMB) given during surgery.

Sugammadex intravenously as a single bolus injection after surgery.

Pain assessment done at about 15, 45, and 90 minutes after surgery.

干预措施: Sugammadex (Drug)

Deep Neuromuscular Blockade (NMB) + Sugammadex

Experimental

Deep Neuromuscular Blockade (NMB) given during surgery.

Sugammadex intravenously as a single bolus injection after surgery.

Pain assessment done at about 15, 45, and 90 minutes after surgery.

干预措施: Pain Assessment (Behavioral)

Moderate Neuromuscular Blockade (NMB) + Neostigmine

Experimental

Moderate Neuromuscular Blockade (NMB) given during surgery.

Neostigmine intravenously slowly over a period of at least 1 minute after surgery.

Pain assessment done at about 15, 45, and 90 minutes after surgery.

干预措施: Moderate Neuromuscular Blockade (NMB) (Drug)

Moderate Neuromuscular Blockade (NMB) + Neostigmine

Experimental

Moderate Neuromuscular Blockade (NMB) given during surgery.

Neostigmine intravenously slowly over a period of at least 1 minute after surgery.

Pain assessment done at about 15, 45, and 90 minutes after surgery.

干预措施: Neostigmine (Drug)

Moderate Neuromuscular Blockade (NMB) + Neostigmine

Experimental

Moderate Neuromuscular Blockade (NMB) given during surgery.

Neostigmine intravenously slowly over a period of at least 1 minute after surgery.

Pain assessment done at about 15, 45, and 90 minutes after surgery.

干预措施: Pain Assessment (Behavioral)

结局指标

主要结局

Percentage of Patients Who Reported Shoulder Pain

时间窗: 30 days

Visual Analog Scale (VAS) pain score (0-10) for shoulder pain recorded, where 0 means no pain and 10 means the worst pain ever experienced . Percentage of participants who experienced should pain.

次要结局

  • Cumulative Intraoperative Insufflation Pressure(Day 0 - IntraOperative-From beginning of pneumoperitoneum to desufflation (an average of 166 minutes))
  • Percentage of Muscle Response Using Train-of-Four (TOF) in Post-Anesthesia Care Unit (PACU) to Measure Residual Muscle Relaxation(Day 0 - Arrival time at PACU, an average of 3 minutes)
  • Readiness to Discharge From the Post-Anesthesia Care Unit (PACU)(Assessed at 15, 45, 90 minutes during PACU stay.)
  • Percentage of Participants With Nausea and/or Vomiting in PACU(Day 0 - PACU stay, an average of 120 minutes)
  • Surgical Exposure Grading(Day 0 - IntraOperative, from incision time to closing time(average 190 minutes))
  • Length of Hospital Stay(length of hospital stay(average of 3 days))

研究者

申办方类型
Other
责任方
Sponsor

研究点 (1)

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