Residual Paralysis and Reversal With Routine Neostigmine Versus Half-dose Sugammadex and Routine Neostigmine
Neuromuscular Blockade, Sugammadex, Neostigmine
About this trial
This is an interventional treatment trial for Neuromuscular Blockade focused on measuring Residual Curarization, Postoperative, Complication, Neuromuscular blockade, Neostigmine, Sugammadex, Rocuronium
Eligibility Criteria
Inclusion Criteria:
- Inclusion criteria:
- 40 and 65 years of age,
- American Society of Anesthesiologists Physical Status (ASA-PS) of 3 and 4,
- Elective lower gastrointestinal tumor resection surgeries,
- Supine positioning,
- Surgery requiring use of general anesthesia and muscle relaxation,
- Use of inhalational agent of sevoflurane anesthesia,
- Surgical duration of about three to six hours.
Exclusion Criteria:
- History of known or suspected neuromuscular disease,
- History of renal or hepatic dysfunction,
- Hyperkalemia,
- Patients receiving antibiotics, anticonvulsants, or magnesium,
- History of stroke,
- History of glaucoma,
- History of pregnancy or breastfeeding,
- Suspicion of abdominal infection or sepsis,
- Suspected history of malignant hyperthermia,
- An allergy to medications used during general anesthesia
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Active Comparator
Active Comparator
Neostigmine
Neostigmine and Sugammadex
The Group N (Neostigmine) (n=48), patients received standard intravenous neostigmine 0.05 mg/kg and atropine 0.02 mg/kg doses before extubation. A train-of-four (TOF) count of 2 in TOF Watch monitoring provides information of a shallow neuromuscular block. If at least two twitches are on the TOF watch monitor, the study investigators administer reversal medication for neuromuscular blockade in both groups. At this point, depending on randomization, a reversal agent is administered for each randomized group by an anesthesia resident or nurse who is blinded to the study protocol. The study investigators record the recovery periods between the start of administering the reversal agent to the recovery of TOF ratio < 0.9 to 0.7 and TOF ratio ≥ 0.9 if it occurs. These time periods are in minutes.
In Group N+S (Neostigmine+Sugammadex) (n=50), patients received standard intravenous neostigmine 0.05 mg/kg and atropine 0.02 mg/kg doses before extubation. After a three-minute waiting period, the study investigators administered an intravenous bolus half-dose of 1 mg/kg of sugammadex after the standard reversal dose. A train-of-four (TOF) count of 2 in TOF Watch monitoring provides information of a shallow neuromuscular block. If at least two twitches are on the TOF watch monitor, the study investigators administer reversal medication for neuromuscular blockade in both groups. At this point, depending on randomization, a reversal agent is administered for each randomized group by an anesthesia resident or nurse who is blinded to the study protocol. The study investigators record the recovery periods between the start of administering the reversal agent to the recovery of TOF ratio < 0.9 to 0.7 and TOF ratio ≥ 0.9 if it occurs. These time periods are in minutes.