Supratentorial Brain Tumor Surgery Clinical Trial
Official title:
Cerebral Oxygenation and Metabolism After Reversal Of Rocuronium Neuromuscular Blockade In Cases Of Supratentorial Tumors: A Comparative Study Between Sugammadex Versus Neostigmine
Cholinesterase inhibitors such as Neostigmine and Edrophonium have been used to reverse
neuromuscular blockade after surgery. However, these drugs have a relatively slow onset and
have adverse effects associated with stimulation of muscarinic receptors. In addition,
neostigmine cannot be used to reverse profound blockade.
Anesthetics may exert their effects on various facets of cerebral function such as cerebral
metabolic rate (CMRO2), cerebral blood flow (CBF), cerebral blood flow-metabolism coupling,
intra cranial pressure (ICP), autoregulation, vascular response to CO2 and brain electrical
activity. The net result of all these effects of the anaesthetic agents combined with their
systemic effects may prove beneficial or detrimental to an already diseased brain.
In neurosurgical patients, clear and rapid recovery is required to early assess the
neurological status and to maintain the cerebral oxygenation and metabolism within the normal
physiological values which may be saved by sugammadex.
The aim of this study is to compare Sugammadex versus neostigmine as a reversal to the
neuromuscular blockade of rocuronium in patients undergoing supratentorial tumors resection.
Comparison will include hemodynamics, respiratory effort and degree of sedation.
Indicators of global cerebral oxygenation and haemodynamics will be calculated using jugular
bulb and peripheral arterial blood sampling.
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