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Clinical Trial Details — Status: Terminated

Administrative data

NCT number NCT03962725
Other study ID # 2019P000260
Secondary ID
Status Terminated
Phase Phase 4
First received
Last updated
Start date August 7, 2019
Est. completion date December 19, 2022

Study information

Verified date January 2023
Source Beth Israel Deaconess Medical Center
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The goal of this study to evaluate whether eliminating the use of non-depolarizing neuromuscular blocking agents (NMBA) for maintenance of general anesthesia reduces postoperative pulmonary complications in higher risk patients.


Description:

Pragmatic prospective randomized controlled assessor-blinded effect-size finding trial involving approximately 100 patients total at two academic tertiary care hospitals: Beth Israel Deaconess Medical Center (BIDMC) and Massachusetts General Hospital (MGH). Patients will be randomized into one of two study groups: standard care group which uses Rocuronium (NMBA) as an adjunct for maintenance of general anesthesia and non-relaxant arm that avoids the use of NMBA and instead uses additional inhalational anesthetics, opioids, propofol, dexmedetomidine, or ketamine for maintenance of general anesthesia. Assessment of postoperative pulmonary complications and in-hospital mortality would be achieved by close review of the patient's medical records during the hospital stay, for a maximum of 28 days.


Recruitment information / eligibility

Status Terminated
Enrollment 3
Est. completion date December 19, 2022
Est. primary completion date December 19, 2022
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - At least 18 years of age - Undergoing non-cardiac surgery under general anesthesia with an endotracheal tube - those at higher risk of developing postoperative pulmonary complications (internally validated risk prediction score of >=20) Exclusion Criteria: - Emergency surgery - Ambulatory (outpatient) surgery - Scheduled for elective postoperative ventilation - Planned return to operating room within 7 days of index procedure - Exposure to general anesthesia within 7 days prior to planned procedure - Requirement mechanical ventilation at baseline (not including stable use of CPAP/BiPAP) - Pregnant patients: as detected by patient self-reporting or diagnosed by preoperative pregnancy testing according to institutional policies at BIDMC and MGH - Allergy to either non-depolarizing muscle relaxants or sugammadex - Clinician refusal - Prisoner

Study Design


Intervention

Drug:
Neuromuscular Blocking Agents
Use of non depolarizing neuromuscular blocking agents for maintenance of general anesthesia.
Anesthetic Adjuncts
Use of deeper plane of inhaled anesthetics or adjuncts (opioids, propofol, dexmedetomidine or ketamine for maintenance of general anesthesia.

Locations

Country Name City State
United States Beth Israel Deaconess Medical Center Boston Massachusetts
United States Massachusetts General Hospital Boston Massachusetts

Sponsors (1)

Lead Sponsor Collaborator
Beth Israel Deaconess Medical Center

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Other 30-Day Readmission Rates How often patients had to be readmitted to the hospital within 30 days of discharge from hospital following index procedure. 30 days
Other Time to Post-Anesthesia Care Unit (PACU) Discharge Readiness Time is takes for patients to be ready for discharge from PACU post operatively. Day after surgery
Other Cost of Anesthetic Medication Cost of anesthetics used during surgical procedures in the study. During the surgery
Other Rate of Unplanned ICU Admission or Return to Operating Room How often patients had either unanticipated ICU admissions or return to the operating room within 24 hours of the initial operation. 24 hours
Other Hospital Length of Stay How much total time patients spent in the hospital after the operation. Upto 30 days
Primary Number of participants who either had postoperative pulmonary complications or died in hospital within 28 days of index procedure. Composite of respiratory failure, suspected respiratory infection, aspiration pneumonia or pneumonitis, atelectasis, bronchospasm, reintubation and all cause in-hospital mortality 28 Days
Secondary Vasopressor Use Between Groups Vasopressor equivalent dose During the surgery
Secondary Duration of Intraoperative Hypotension Mean arterial pressure <55mmHg During the surgery
Secondary Surgeon's Assessment of surgical field Was the operative condition optimal for the surgeon graded qualitatively using a numerical rating scale of 1-4. A score of 1 indicates excellent operating conditions whereas 4 indicates conditions unacceptable to the surgeon. During the surgery
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