Reversal With Low Doses of Sugammadex in Patients Undergoing Non-cardiac Surgery
Postoperative Residual CurarizationNeuromuscular BlockNeuromuscular blocking agents (NMBA) are among the most commonly used drugs during general anesthesia and may induce complete muscle paralysis.They are used clinically to facilitate endotracheal intubation and to optimize surgical working conditions. Incomplete recovery from non-depolarising NMBAs continues to be a common problem in modern postoperative care unit and is associated with significant risk of microaspiration and hypoventilation which leads to pulmonary complications.Recently effective reversal of neuromuscular blockade has been described by use of lower dose of sugammadex the recommended without providing adequate answer to whether the lower dose is safe enough to avoid recurrent block. Hypotheses: Administration of sugammadex 0.25 mg/kg at TOF ratio 0.3 will successfully reverse (TOF=0.9) rocuronium induced neuromuscular block within 10 min. Recurrent block (TOF ratio < 0.9) does not occur after reversal with low dose sugammadex 0.25 mg/kg. The primary objective of this trial is to assess the dose-response characteristics of sugammadex in reversing rocuronium induced neuromuscular block and to identify the minimal effective dose Secondary objective is to assess the safety of different doses of sugammadex (recurrent block (TOF ratio < 0.9) after reversal and the occurrence of adverse reactions) Sugammadex is a very expensive drug which limits its use i anaesthesia department. By optimising drug dosage it may have economic impact and contribute to a wider use of sugammadex to reverse neuromuscular block before extubation and thus avoid incomplete recovery. This may lead to less risk for postoperative pulmonary complications and thereby reduce morbidity and mortality after surgery.
Recovery of Muscle Function After Deep Neuromuscular Block by Means of Diaphragm Ultrasonography...
Post-operative Residual CurarizationDiaphragm ultrasonography as a diagnostic tool in order to demonstrate the superiority of Sugammadex vs. AChEI in facilitating post-operative neuromuscular recovery.
Virtual Reality in the Operating Room
AnesthesiaIntravenous5 moreThis is a randomized, controlled trial designed to investigate whether the use of virtual reality immersive relaxation during hand/arm operations can allow for a relaxing operating room experience for patients while potentially reducing anesthesia requirements.
Different Doses of Neostigmine for Reversal of Moderate Neuromuscular Blockade in Children
Neuromuscular BlockadeNeuromuscular Block2 moreThere is no recent information on the required dose of neostigmine for the reversal of cisatracurium-induced moderate neuromuscular blockade (NMB) [Train-of-four (TOF) count = 1-3)] in children. The aim of this study will be to evaluate by means of a prospective, randomized and double-blinded clinical trial, the time required for reversal of moderate NMB (TOFc 3) to T4/T1 (TOF ratio, TOFr) > 0.9 and TOFr = 1.0 after administration of different doses of neostigmine (10, 20 or 30 mcg/kg) or placebo in children undergoing inhalational (sevoflurane) general anesthesia. In addition, the probability of NMB reversal in less than 10 minutes, the presence of bradycardia, respiratory complications and postoperative vomiting will be evaluated. The time for reversal is expected to be inversely proportional to the administered dose of neostigmine.
Effect of Calling the Patient's Name on Recovery From General Anesthesia
Delayed Emergence From AnesthesiaThe purpose of this study is to find if we can shorten the recovery time by calling the patient's name during anesthesia reversal.
Algorithm of Muscle Function Tests to Detect Residual Neuromuscular Blockade.
Postoperative Residual CurarizationObjective neuromuscular monitoring is the gold standard to detect postoperative residual curarization (PORC). Many anesthesiologist just use qualitative neuromuscular monitoring or unreliable, clinical tests. Goal of this study is to develop an algorithm of muscle function tests to identify PORC
Three Different Doses of Neostigmine on the Reversal of Cisatracurium-induced Moderate Neuromuscular...
Neuromuscular BlockadeNeuromuscular Blockade1 moreThe aim of the present study will be to evaluate by means of a prospective randomized clinical trial, the time required for the reversal of moderate neuromuscular blockade (NMB) (Train-of-four count = 3; TOFc 3) to Train-of-four ratio (TOFr) > 0.9 and TOFr = 1.0 after administration of different doses of neostigmine (30, 50 and 70 mcg/kg) in patients undergoing general anesthesia with propofol or sevoflurane. In addition, the probability of NMB reversal in less than 10 minutes or 15 minutes after neostigmine administration will be registered.
A Study of Residual Curarization Incidence in China
Perioperative/Postoperative ComplicationsPORC (Postoperative Residual Curarization)The purpose of this study is to determine the incidence of residual curarization in PACU and relevant risk factors.
Postoperative Residual Paralysis After Cardiac Surgery
Postoperative Residual CurarizationThe main objective of this study is to describe the incidence of postoperative residual paralysis (mean train-of-four <90%) when weaning from the ventilator in patients admitted to the Intensive Care Unit (ICU) after elective cardiac surgery. Train-of-four monitoring is a widely used term for the peripheral nerve stimulation used in neuromuscular blockade monitoring. When the patient is ready for weaning from the ventilator, an ICU doctor will perform a measurement of the train-of-four at the thumb with a neuromuscular transmission monitor. Every value below 90% will be considered as residual paralysis and treated appropriately by means of a reversal agent.
Comparison Between Cisatracurium and Rocuronium in Terms of Recovery of the Muscular Strength in...
Postoperative Residual CurarizationResidual Neuromuscular BlockThe purpose of this study is to determine the incidence of post-operative residual curarization in our patients and to determine if Cisatracurium and Rocuronium behave differently from each other in terms of residual curarization.