Neuromuscular Monitoring Clinical Trial
Official title:
Does Intraoperatively Administered Methylprednisolone Prolong the Neuromuscular Blocade Reversal Effect of Sugammadex?
Sugammadex, a modified γ-cyclodextrin is a selective relaxant-binding agent that reverses the
effects of steroidal neuromuscular blocking agents, rocuronium and vecuronium. It shows its
activity by encapsulating these. Likewise, some other steroid hormones and drugs like
flucloxacillin, toremifene, fusidic acid can also be effected. Thus, assuming that
methylprednisolone would also be encapsulated by sugammadex and decrease its efficiency, in
this study we aimed to compare the recovery times from recuronium-induced muscle relaxation
after reversal with sugammadex between patients who receive intraoperative methylprednisolone
or not.
After institutional review board (IRB) approval and informed consent, 100 patients will be
enrolled in this prospective, single center, controlled study. Anaesthesia will be induced
with propofol (3mg/kg) and rocuronium (0.6 mg/kg), followed by sevoflurane maintenance.
Patients will be divided randomly into two groups methylprednisolone administered group and
control group respectively). Neuromuscular blockade will be monitored using calibrated
acceleromyography train-of-four (TOF WATCH SX Organon Ltd, Dublin, Ireland). Once
rocuronium-induced neuromuscular blockade recovers spontaneously to TOF-count-two, all
patients will receive 2.0 mg/kg of sugammadex. Neuromuscular monitoring will be continued
until recovery of the TOF ratio to 0.9 at the ulnar nerve. The time to recovery of TOF to 0.9
will be compared in both groups. The statistical analyses will be performed using Student T
Test and Mann-Whitney U test.
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