Surgery Clinical Trial
Official title:
Comparison of Operating Conditions, Postoperative Recovery and Overall Satisfaction Between Deep and Restricted Neuromuscular Blockade for Spinal Surgery Under General Anesthesia
Verified date | September 2017 |
Source | Korea University Guro Hospital |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
The investigators aim to investigate operating conditions, postoperative recovery and overall satisfaction of surgeons between deep neuromuscular blockade (NMB) group and restricted NMB group during spinal surgery under general anesthesia. The investigators hypothesize that this study can present good surgical conditions, postoperative recovery outcomes and overall satisfaction of surgeons in deep NMB group, thereby proving the advantages of deep NMB as well as flaws of restricted NMB in spine surgeries.
Status | Completed |
Enrollment | 90 |
Est. completion date | February 16, 2017 |
Est. primary completion date | February 16, 2017 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years to 75 Years |
Eligibility |
Inclusion Criteria: - American Society of Anesthesiologists (ASA) physical status I-II adult patients scheduled for elective spinal (cervical or lumbar) surgery under general anesthesia Exclusion Criteria: - Pregnancy - Present medication known to interfere with neuromuscular blockade - Diseases affecting neuromuscular transmission - History of hypersensitivity on rocuronium or sugammadex - Emergent spinal surgery - Spinal surgeries which have lesions more than 3 spinal levels - Spinal surgeries which have duration less than 1 hour - Spinal surgeries which are not performed under prone position - Spinal surgeries which are not performed under total intravenous anesthesia (TIVA). - Patients who will have hemodynamic instability (mean blood pressure increase or fall of > 30% from baseline lasting for more than 5 min) during surgery - Patients who will have blood loss > 1 L during surgery - MEP monitored spinal surgeries |
Country | Name | City | State |
---|---|---|---|
Korea, Republic of | Korea University Guro Hospital | Seoul |
Lead Sponsor | Collaborator |
---|---|
Korea University Guro Hospital | Merck Sharp & Dohme Corp. |
Korea, Republic of,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Mean Value of Peak Inspiratory Pressure | This outcome is the mean value of the peak inspiratory pressure measured at each 15 minute during the anesthesia, which can reflect the degree of the tone of respiratory muscles. As muscle tone increases, airway pressure usually increases due to increased tone of abdominal muscle and respiratory muscles including diaphragm. The longer the surgery goes, the higher the airway pressure gets. Also, as neurospinal surgeries are operated in the prone position, the potential for increased airway pressure is high. As airway pressure gets higher, intrathoracic pressure and intraabdominal pressure also become higher. These consequences may bring about similar results with detrimental effects derived from marked increase in intraabdominal pressure in laparoscopic abdominal surgeries | Every 15 minutes during anesthesia, up to 3 hours? | |
Secondary | Mean Value of Pressure of Back Muscle Retractor | Mean value of pressure of back muscle retractor placed in the operating site (recorded every 15 minutes during the placement of the retractor): measured by the pressure probe placed between the retractor and the back muscle. | Every 15 minutes at the period of the retractor placement during surgery, up to 2 hours? | |
Secondary | Overall Satisfaction of Surgeons for the Surgical Condition | Overall satisfaction of surgeons for the surgical condition will be assessed by the surgeons who perform surgery using numerical rating scale (NRS; 1-10) after surgery (1, worst; 10, best). | After surgery | |
Secondary | The Muscle Tone | The muscle tone of each patient at the screw insertion through the pedicle of spine during surgery scaled by surgeons (1: muscle tone is good, suitable for surgery; 2: muscle tone is moderate, but do not affect the operation; 3: muscle tone is hard, making the operation difficult.). | at the screw insertion through the pedicle of spine during surgery | |
Secondary | The Number of Body Movements | The number of body movements (including cough or any diaphragm movement) observed during the surgery. | At the occurrence of the event during surgery, up to 3 hours | |
Secondary | The Degree of Bleeding | 2.The degree of bleeding of each patient scaled by surgeons (Intraoperative scale for assessment of operating condition of surgical field: 0 - No bleeding, 1 - Slight bleeding - no suctioning of blood required, 2 - Slight bleeding - occasional suctioning required but not threatened the operative field, 3 - Slight-bleeding - frequent suctioning of blood was required that threatens the operative field a few seconds after suctioning, 4 - Moderate bleeding - frequent suctioning of blood was required which threatens the operative field directly after suctioning, 5 - Severe bleeding - continuous suctioning of blood was required which severely threatened the operative field make the surgery not possible). | Continuously observed during the whole period of surgery, up to 3 hours | |
Secondary | Recovery Time (Time to Reach Sedation Score 5 at Postanesthesia Care Unit (PACU). | the time to reach sedation score 5 (the Observer's Assessment of Alertness/ Sedation (OAA/S) score; awake, 5 to unresponsive, 1) at PACU | every 10 min for 1 hour at PACU. | |
Secondary | Adverse Events : The Postoperative Nausea and Vomiting Occurrence in Subject | The occurrence of any adverse events was recorded in the post-anesthesia care unit (PACU) and a ward during the postoperative 24 hours. | during the postoperative 24 hours |
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