Neuromuscular Blockade Clinical Trial
Official title:
Small Dose of Sugammadex Improves Muscle Function After Standard Neuromuscular Recovery (TOF 0.9)
This study is designed to investigate, whether Sugammadex improves muscle function after standard neuromuscular recovery (TOF 0.9) from relaxation with rocuronium.
Muscle relaxants are an integral part of today's anesthesia. They improve intubating
conditions and reduce doses of other substances needed for general anesthesia. For ensuring
patient safety, neuromuscular function is monitored during general anesthesia. The latter
one is only terminated, when neuromuscular monitoring shows an objective normal value.
Despite this accurate surveillance, a lot of patients complain about subjectively
uncomfortable muscle weakness in the recovery room. A possible explanation for this
ostensive contradiction can be the variable "margin of safety" of neuromuscluar transmission
in different muscle groups. Waud et al describe this phenomenon, as the fact, that
neuromuscular transmission is only clinically detectable, when a certain number of
post-synaptic receptors is not blocked. The necessary fraction of free receptors differs a
lot between the muscle groups (15-50%). As neuromuscular monitoring only measures one muscle
group exemplarily, and a clinically non-detectable number of post-synaptic receptors can be
blocked shortly after anesthesia, the subjective muscle weakness of patients could need
treatment.
Sugammadex can encapsulate steroid-typ muscle relaxants within 2 to 5 minutes. After
applying a sufficiently high dose, also those receptors will be free that elude
neuromuscular monitoring. This constellation brings up the interesting problem to quantify
the possible effect on patients' subjective muscle weakness.
This study is designed to investigate, if the application of sugammadex improves muscle
function and consequently well-being of patients, that have been extubated according to
clinical standard.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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