search
Back to results

Recovery of Diaphragmatic Function After Neuromuscular Blockade and Sugammadex (SUDIA)

Primary Purpose

Diaphragmatic Dysfunction, Muscle Weakness, Muscle Fatigue

Status
Completed
Phase
Phase 3
Locations
Belgium
Study Type
Interventional
Intervention
sugammadex 2mg/kg
neostigmine
sugammadex 4mg/kg
placebo
Single rocuronium dose
Repeated rocuronium dose
Continuous rocuronium infusion
Sponsored by
University Hospital, Antwerp
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diaphragmatic Dysfunction

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Each participant must have the mental capacity to decide whether he/she takes part in the trial or not. Each participant must voluntarily give his/her written informed consent. In case a participant is physically unable to give a written informed consent, a legal representative is to perform this.
  • Each participant must be at least eighteen years of age. Participants can be of either sex and of any ethnical background.
  • Each participant must meet the American Society of Anesthesiologists class II, II or III criteria.
  • Each participant must be scheduled for intracranial surgery. During general anesthesia rocuronium must be used as a neuromuscular blocking agent.
  • Each participant must be a suitable candidate for the rapid reversal of the neuromuscular blockade.
  • Each female participant of sexually active age and of childbearing potential must agree to the use of a medically accepted method of contraception through seven days after the day of surgery. Postmenopausal (defined as at least twelve consecutive months without spontaneous menstrual period) women are not obliged to use contraceptives.

Exclusion Criteria:

  • The participant is known or suspected to have a neuromuscular disorder.
  • The participant is known or suspected to have an allergic reaction to sugammadex, rocuronium, anesthetic or narcotic medications, or any drugs used during general anesthesia.
  • The participant is known or suspected to have an anatomical malformation impeding a proper intubation.
  • The participant is known or suspected to have a history of malignant hyperthermia.
  • The participant is pregnant (or intends to become pregnant within the presurgical period) or lactating.
  • The participant is known to have a renal insufficiency (defined as a serum creatinine concentration of two times the upper limit, or a glomerular filtration rate of less than 60 ml/min).
  • The participant is known or suspected to have a chronic obstructive pulmonary disease GOLD classification 2 or higher or has any respiratory disease that impairs his respiratory function to a NYHA III level or worse.
  • The participant is known to have an infection of the upper or lower airways, as diagnosed by clinical or laboratory findings.
  • The participant is known or suspected to have congestive heart failure.
  • The participant is obese, as defined by a body mass index of 30 kg/m2 or more.
  • The participant is known or suspected to have a major hepatic dysfunction.
  • The participant has received or is scheduled to receive toremifene and/or an intravenous administration of fusidic acid within a time span of twenty-four hours before and twenty-four hours after the surgery.
  • The participant is known or suspected to have any condition contraindicating the administration of sugammadex, neostigmine, glycopyrrolate or placebo.
  • The participant is known or suspected to be directly involved in this study and/or is employed by or is a family member of any person employed by the investigator, at the investigational site, or by the sponsor.

Sites / Locations

  • Antwerp University Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Placebo Comparator

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Arm Label

Single rocuronium dose - placebo

Single rocuronium dose - sugammadex

Repeated rocuronium dose - neostigmine

Repeated rocuronium dose - sugammadex

Continuous rocuronium dose

Arm Description

The patients will receive a single rocuronium dose, and no reversal agent.

The patients will receive a single rocuronium dose and sugammadex 2mg/kg as a reversal agent

The patients will receive multiple rocuronium doses and neostigmine 70 mcg/kg as a reversal agent

The patients will receive multiple rocuronium doses and neostigmine 2mg/kg as a reversal agent

The participants will receive a continuous rocuronium infusion and sugammadex 4 mg/kg as a reversal agent

Outcomes

Primary Outcome Measures

Electric Activity of the Diaphragm (Microvolts)

Secondary Outcome Measures

Electric Activity of the Intercostal Muscles

Full Information

First Posted
October 9, 2013
Last Updated
March 21, 2018
Sponsor
University Hospital, Antwerp
search

1. Study Identification

Unique Protocol Identification Number
NCT01962298
Brief Title
Recovery of Diaphragmatic Function After Neuromuscular Blockade and Sugammadex
Acronym
SUDIA
Official Title
Sugammadex and the Diaphragm: Recovery of Diaphragmatic Function and Neuromuscular Blockade. A Double-blind Randomized Controlled Trial
Study Type
Interventional

2. Study Status

Record Verification Date
March 2018
Overall Recruitment Status
Completed
Study Start Date
October 2013 (undefined)
Primary Completion Date
December 2014 (Actual)
Study Completion Date
December 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University Hospital, Antwerp

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The effect of neuromuscular blocking agents (NMBA, e.g. rocuronium) on respiratory muscle activity is well known. However, since the availability of sugammadex, to our knowledge, no study has been conducted to evaluate the effect of this novel product on these muscles. Our hypothesis is that by applying a different strategy in the use of neuromuscular blocking agents and their reversal agents we might see a different activity of the respiratory muscles.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diaphragmatic Dysfunction, Muscle Weakness, Muscle Fatigue

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderOutcomes Assessor
Allocation
Randomized
Enrollment
75 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Single rocuronium dose - placebo
Arm Type
Placebo Comparator
Arm Description
The patients will receive a single rocuronium dose, and no reversal agent.
Arm Title
Single rocuronium dose - sugammadex
Arm Type
Active Comparator
Arm Description
The patients will receive a single rocuronium dose and sugammadex 2mg/kg as a reversal agent
Arm Title
Repeated rocuronium dose - neostigmine
Arm Type
Active Comparator
Arm Description
The patients will receive multiple rocuronium doses and neostigmine 70 mcg/kg as a reversal agent
Arm Title
Repeated rocuronium dose - sugammadex
Arm Type
Active Comparator
Arm Description
The patients will receive multiple rocuronium doses and neostigmine 2mg/kg as a reversal agent
Arm Title
Continuous rocuronium dose
Arm Type
Active Comparator
Arm Description
The participants will receive a continuous rocuronium infusion and sugammadex 4 mg/kg as a reversal agent
Intervention Type
Drug
Intervention Name(s)
sugammadex 2mg/kg
Intervention Type
Drug
Intervention Name(s)
neostigmine
Intervention Type
Drug
Intervention Name(s)
sugammadex 4mg/kg
Intervention Type
Drug
Intervention Name(s)
placebo
Intervention Type
Drug
Intervention Name(s)
Single rocuronium dose
Intervention Type
Drug
Intervention Name(s)
Repeated rocuronium dose
Intervention Type
Drug
Intervention Name(s)
Continuous rocuronium infusion
Primary Outcome Measure Information:
Title
Electric Activity of the Diaphragm (Microvolts)
Time Frame
From the start of spontaneous breathing till extubation, limited to maximum ten minutes after the onset of spontaneous breathing
Secondary Outcome Measure Information:
Title
Electric Activity of the Intercostal Muscles
Time Frame
From the start of spontaneous breathing till extubation, limited to maximum ten minutes after the onset of spontaneous breathing
Other Pre-specified Outcome Measures:
Title
Centroid Frequency of the EMG, as Trend Variability (Change in %) From First to Last Recording
Time Frame
From the start of spontaneous breathing till extubation, limited to maximum one hour after the onset of spontaneous breathing

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Each participant must have the mental capacity to decide whether he/she takes part in the trial or not. Each participant must voluntarily give his/her written informed consent. In case a participant is physically unable to give a written informed consent, a legal representative is to perform this. Each participant must be at least eighteen years of age. Participants can be of either sex and of any ethnical background. Each participant must meet the American Society of Anesthesiologists class II, II or III criteria. Each participant must be scheduled for intracranial surgery. During general anesthesia rocuronium must be used as a neuromuscular blocking agent. Each participant must be a suitable candidate for the rapid reversal of the neuromuscular blockade. Each female participant of sexually active age and of childbearing potential must agree to the use of a medically accepted method of contraception through seven days after the day of surgery. Postmenopausal (defined as at least twelve consecutive months without spontaneous menstrual period) women are not obliged to use contraceptives. Exclusion Criteria: The participant is known or suspected to have a neuromuscular disorder. The participant is known or suspected to have an allergic reaction to sugammadex, rocuronium, anesthetic or narcotic medications, or any drugs used during general anesthesia. The participant is known or suspected to have an anatomical malformation impeding a proper intubation. The participant is known or suspected to have a history of malignant hyperthermia. The participant is pregnant (or intends to become pregnant within the presurgical period) or lactating. The participant is known to have a renal insufficiency (defined as a serum creatinine concentration of two times the upper limit, or a glomerular filtration rate of less than 60 ml/min). The participant is known or suspected to have a chronic obstructive pulmonary disease GOLD classification 2 or higher or has any respiratory disease that impairs his respiratory function to a NYHA III level or worse. The participant is known to have an infection of the upper or lower airways, as diagnosed by clinical or laboratory findings. The participant is known or suspected to have congestive heart failure. The participant is obese, as defined by a body mass index of 30 kg/m2 or more. The participant is known or suspected to have a major hepatic dysfunction. The participant has received or is scheduled to receive toremifene and/or an intravenous administration of fusidic acid within a time span of twenty-four hours before and twenty-four hours after the surgery. The participant is known or suspected to have any condition contraindicating the administration of sugammadex, neostigmine, glycopyrrolate or placebo. The participant is known or suspected to be directly involved in this study and/or is employed by or is a family member of any person employed by the investigator, at the investigational site, or by the sponsor.
Facility Information:
Facility Name
Antwerp University Hospital
City
Edegem
State/Province
Antwerpen
ZIP/Postal Code
2650
Country
Belgium

12. IPD Sharing Statement

Citations:
PubMed Identifier
23011532
Citation
Dres M, Schmidt M, Ferre A, Mayaux J, Similowski T, Demoule A. Diaphragm electromyographic activity as a predictor of weaning failure. Intensive Care Med. 2012 Dec;38(12):2017-25. doi: 10.1007/s00134-012-2700-3. Epub 2012 Sep 26.
Results Reference
background
PubMed Identifier
31629404
Citation
Schepens T, Janssens K, Maes S, Wildemeersch D, Vellinga J, Jorens PG, Saldien V. Respiratory muscle activity after spontaneous, neostigmine- or sugammadex-enhanced recovery of neuromuscular blockade: a double blind prospective randomized controlled trial. BMC Anesthesiol. 2019 Oct 19;19(1):187. doi: 10.1186/s12871-019-0863-y.
Results Reference
derived

Learn more about this trial

Recovery of Diaphragmatic Function After Neuromuscular Blockade and Sugammadex

We'll reach out to this number within 24 hrs