The Difference in the Current Intensity for the Obturator Nerve Block According to the Presence or Absence of Neuromuscular Blockage
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 30
- 试验地点
- 1
- 主要终点
- Initial current intensity
研究概览
简要总结
The purpose of the present study was to find out the difference in current intensity required for nerve stimulation according to the presence or absence of neuromuscular blockade during the obturator nerve block procedure for TURP.
详细描述
During the transurethral resection of bladder tumors (TURBT) procedure under spinal anesthesia, the obturator nerve block is required to prevent the accidental movement of adductor longus muscles by electrical stimulation. However, during general anesthesia, the contraction of the adductor longus muscle would be lost due to deep neuromuscular blockade. However, some reports showed that the contraction of the adductor longus muscle occurs even in the deep neuromuscular blockade.
The current intensity for the nerve stimulation during nerve block is 0.3--0.5 mA when the needle tip is near the nerve. However, it is still unknown what current intensity is required to show the contraction of the adductor longus muscle when the patient is in a deep neuromuscular blockade.
Therefore, in this study, investigators aimed to determine the difference in current intensity required for nerve stimulation according to the presence or absence of neuromuscular blockade during obturator nerve block for TURP. In addition, investigators aimed to determine that the obturator nerve block is required during the TURP procedure in patients with deep neuromuscular blockade during general anesthesia.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Other
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients undergoing TURP procedure
排除标准
- •Patients with anatomical or functional anomaly in the upper airways
- •Patients with neuromuscular disease
- •Patients with hip joint disorders
- •BMI of < 18.5 or > 30.0 kg/m2
研究组 & 干预措施
Current intensity
- An I-gel mask is inserted for the mechanical ventilator of the patient who is sedated with propofol.
- For the ultrasound-guided obturator nerve (ON) block, and needle tip gradually advanced to the anterior branch of the ON. The current intensity for the stimulation of ON starts at 1.0 mA (using the sequential electrical nerve stimulation mode), and the needle is advanced gradually to the location where the contraction of the adductor longus muscle (ALM) occurs at 0.3-0.5 mA.
- After fixing the needle in that position, measure the current intensity.
- Then, rocuronium (0.6 mg/kg) is administered under quantitative neuromuscular-blockade monitoring.
- When the train-of-four count becomes 0, the current intensity is increased until the contraction of the ALM occurs.
- The current intensity is measured when the contraction of the ALM occurs.
干预措施: Rocuronium Bromide (Drug)
Current intensity
- An I-gel mask is inserted for the mechanical ventilator of the patient who is sedated with propofol.
- For the ultrasound-guided obturator nerve (ON) block, and needle tip gradually advanced to the anterior branch of the ON. The current intensity for the stimulation of ON starts at 1.0 mA (using the sequential electrical nerve stimulation mode), and the needle is advanced gradually to the location where the contraction of the adductor longus muscle (ALM) occurs at 0.3-0.5 mA.
- After fixing the needle in that position, measure the current intensity.
- Then, rocuronium (0.6 mg/kg) is administered under quantitative neuromuscular-blockade monitoring.
- When the train-of-four count becomes 0, the current intensity is increased until the contraction of the ALM occurs.
- The current intensity is measured when the contraction of the ALM occurs.
干预措施: Nerve stimulator (Diagnostic Test)
结局指标
主要结局
Initial current intensity
时间窗: About 5 minutes after starting obturator nerve block procedure
The current intensity for the stimulation of the obturator nerve starts at 1.0 mA (using the sequential electrical nerve stimulation mode), and the needle is advanced gradually to the location where the stimulus response occurs at 0.3-0.5 mA. After fixing the needle position in a position where contraction of the adductor longus muscle responds to the minimum current intensity, measure the current intensity.
Final current intensity
时间窗: About 10 minutes after starting obturator nerve block procedure
After administration of rocuronium (0.6 mg/kg), when the train-of-four count becomes 0, the current intensity for the stimulation of the obturator nerve is increased until the contraction of the adductor longus muscle occurs. The current intensity is measured when the contraction of the adductor longus muscle occurs.
次要结局
- Current intensity after the administration of rocuronium (0.6 mg/kg)(Between 5 minutes and 10 minutes after starting obturator nerve block procedure)
研究者
Ki Tae Jung
Professor
Chosun University Hospital