Clinical Trials Logo

Clinical Trial Summary

Neuromuscular blocking agents' (NMBA) use during surgery is associated with postoperative respiratory complications and increased risk of readmission to the hospital following ambulatory surgery. Residual neuromuscular block (rNMB) after surgery is difficult to identify. We have recently developed the REsidual neuromuscular block Prediction Score (REPS), that predicts the risk for postoperative rNMB. Our primary objective is now to assess the predictive ability of the REPS for respiratory complications within seven days following general anaesthesia. The secondary objective is to compare the predictive values of REPS and train-of-four (TOF)-ratio below 0.90 for respiratory complications.


Clinical Trial Description

Residual neuromuscular blockade occurs in about 20-60% of patients and depends on compound and dose of NMBA reversal agent used. While on the one hand, NMBAs optimize surgical conditions and facilitate mechanical ventilation in patients with ventilator asynchrony, on the other hand, these agents have been associated with respiratory complications and increased risk of readmission after ambulatory surgery. A consensus in regard to guidelines and thresholds to define the optimal strategy to optimize surgical conditions is yet to be achieved. We have shown that utilization of non-depolarizing muscle relaxants and their reversal agents can be improved by dedicated quality improvement techniques. We have also recently developed the REPS, a tool that predicts postoperative rNMB. This is a retrospective, observational, cohort study based on on-file hospital data from Beth Israel Deaconess Medical Center, Boston, Massachusetts. The primary aim is to validate the dichotomized REPS (high-risk versus low-risk for rNMB which corresponds to a REPS >4 and <4, respectively) for the outcome of postoperative respiratory complications with BIDMC data. The investigators will utilize the pre-defined variables identified to predict residual neuromuscular blockade (REPS) at BIDMC. The secondary aim is to compare the predictive values of the dichotomized REPS with dichotomized train-of-four (TOF)-ratio (low TOF-ratio versus high TOF ratio which corresponds to a TOF-ratio <0.9 and >=0.9, respectively) for respiratory complications. ;


Study Design


Related Conditions & MeSH terms


NCT number NCT03585400
Study type Observational
Source Beth Israel Deaconess Medical Center
Contact
Status Completed
Phase
Start date June 29, 2018
Completion date December 31, 2020

See also
  Status Clinical Trial Phase
Enrolling by invitation NCT04619225 - Cardiac Output and Recovery Time N/A
Recruiting NCT05992090 - Neuromuscular Blockade Monitoring Using Kine-myography vs Electromyography.
Completed NCT02146859 - Predictor of Residual Neuromuscular Blockade in Recovery Room After General Anesthesia
Terminated NCT01678625 - Electromyographic Assessment of Onset and Recovery of Neuromuscular Blockade
Completed NCT03417804 - Incidence of Postoperative Residual Neuromuscular Blockade in Portugal
Completed NCT03111082 - Incidence of Postoperative Neuromuscular Blockade in Post-Anesthesia Care Unit at Parkland Hospital: Does Size Matter?
Completed NCT04244266 - Observational Study in Bariatric Surgery
Completed NCT02939911 - Residual Neuromuscular Blockade in Pediatric Anesthesia
Completed NCT02660398 - Incidence and Severity of Residual Neuromuscular Blockade Phase 4
Completed NCT03920670 - Comparison of the ToFscan and TetraGraph During Recovery of Neuromuscular Function in the Post Anesthesia Care Unit N/A
Completed NCT01837498 - Reversal of Neuromuscular Blockade in Thoracic Surgical Patients
Completed NCT02213848 - Effect of Calcium Chloride on Recovery From Neuromuscular Blockade N/A
Completed NCT04352127 - Visual and Electromyography Assessments in Response to Train-of-Four Stimulation of the Ulnar Nerve N/A
Completed NCT04312256 - Thumb vs Great Toe Recovery N/A
Completed NCT04352140 - Electromyographic and Acceleromyographic Monitoring in Restricted Arm Movement Surgical Setting N/A
Withdrawn NCT03574337 - Residual Neuromuscular Blockade in Cardiac Surgery Patients Phase 4