Anesthesia Clinical Trial
Official title:
A Multi-center, Randomized, Parallel Group, Comparative, Active Controlled, Safety-assessor Blinded, Anesthesiologist-TOF-Watch® SX Blinded Trial Comparing T4/T1 Ratio at Time of Tracheal Extubation Using 4 mg/kg Sugammadex Administered at 1-2 PTCs or Better After the Last Dose of Rocuronium Bromide to 50 µg/kg Neostigmine Administered as Per Standard of Care in Adult Subjects Undergoing Elective Open Abdominal Procedures Requiring Neuromuscular Blockade Reversal
The primary purpose of this study is to compare the incidence of
residual neuromuscular blockade at the time of tracheal extubation after reversal of
rocuronium bromide-induced neuromuscular blockade by 4 mg/kg sugammadex with that of 50
µg/kg neostigmine. Residual neuromuscular blockade is defined as the fourth twitch to first
twitch (T4/T1) ratio of
< 0.90.
Undetected residual neuromuscular blockade is common in the post-anesthesia care
unit (PACU). In fact, 16%-42% of patients receiving intermediate-acting muscle
relaxants in the operating room have T4/T1 ratios <0.7-0.8 in the PACU. Respiratory and
pharyngeal muscle function can be adversely affected during minimal neuromuscular blockade.
Studies in awake volunteers and surgical patients have demonstrated that T4/T1 ratios of 0.7
- 0.9 are associated with impaired airway protective reflexes, upper airway obstruction, a
decreased hypoxic ventilatory response, and post-operative hypoxemia. The incidence and
severity of residual neuromuscular blockade at the time of tracheal extubation will be
evaluated to determine how these influence the length of stay in the operating room and
PACU.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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