Residual neuromuscular blockade and critical respiratory events in the postanesthesia care unit.
Glenn S Murphy, Joseph W Szokol, Jesse H Marymont...
https://pubmed.ncbi.nlm.nih.gov/18635478Actively Recruiting
Age: 18Years - 65Years
All Genders
ID06544980
Measuring Upper Airway Cross Sectional Areas During Residual Neuromuscular Blockade and After Reversal
Led by Tamas Vegh, MD · Updated on 2024-08-12
20
Participants Needed
1
Research Sites
N/A
Total Duration
On this page
AI-Summary
What this Trial Is About
Researchers are studying how the size of the retroglossal pharyngeal airway changes after patients are extubated compared to before muscle relaxation during surgery. They aim to understand the relationship between residual muscle relaxation and airway area, which is important because leftover muscle weakness after surgery can cause breathing problems. This observational study involves patients undergoing surgery with anesthesia where muscle relaxant monitoring is usually not done by the anesthetist. During surgery, anesthesia including muscle relaxants is given based on clinical signs without neuromuscular monitoring by the anesthetist. An independent anesthesiologist continuously monitors muscle relaxant effects using an electromyograph without sharing results with the anesthetist. After surgery, pharyngoscopies are performed before muscle relaxants and after extubation to measure airway areas. If muscle relaxation is still present below a certain threshold, rescue medication to reverse the muscle relaxant may be given. Participants are monitored throughout surgery with standard vital sign devices and neuromuscular monitoring. The study compares airway areas measured during inspiration and expiration at different times and muscle relaxation levels. Data are analyzed statistically to find significant changes. The overall participation includes anesthesia, surgeries lasting at least 30 minutes, airway imaging before and after extubation, and muscle relaxation monitoring. The study ends after collecting and analyzing these measurements.
CONDITIONS
Brief Title
Measuring Upper Airway Cross Sectional Areas During Residual Neuromuscular Blockade and After Reserval
Who Can Participate
Age: 18Years - 65Years
All Genders
Eligibility Criteria
You may qualify if you...
- Age 18 to 65 years
- ASA physical status 1 to 3
- Normal body weight with BMI between 18.5 and 25
- Equal proportion of men and women
- Surgery lasting at least 30 minutes
- Surgery requiring intratracheal intubation
- Patients in supine position during surgery
You will not qualify if you...
- Diseases affecting neuromuscular function such as myopathies or severe liver and kidney failure
- Use of drugs that affect neuromuscular function like magnesium or aminoglycosides
- Difficult airway or expected difficult intubation
- Pregnancy or breastfeeding
- Acute surgery
- Chronic obstructive pulmonary disease (COPD)
- Glaucoma
AI-Screening
AI-Powered Screening
Complete this quick 3-step screening to check your eligibility
1
2
3
Your Study Journey
Screening
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Monitoring
Duration - Duration of surgery (at least 30 minutes)
Participants undergo routine anaesthesia and surgery during which continuous neuromuscular monitoring is performed by an independent anaesthesiologist without affecting the clinical care.
1 visit during surgery (in-person)
Diagnostic Evaluation
Duration - Same day as surgery
Pharyngoscopy and measurement of upper airway cross-sectional areas are performed before muscle relaxant administration and after extubation to assess airway changes.
2 assessments during surgery day (in-person)
Post-operative Follow-up
Duration - Short period immediately after surgery
If necessary, rescue medication is administered after extubation based on neuromuscular monitoring results to reverse residual muscle relaxation.
1 visit after surgery (in-person)
Trial Site Locations
Total: 1 location
1
University of Debrecen
Debrecen, Hajdú-Bihar, Hungary, 4008
Actively Recruiting
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Research Team
L
László Asztalos, MD, PhD
E
Erzsébet Igbonu-Nagy, BSC
How is the study designed?
Study Type
OBSERVATIONAL
Masking
N/A
Allocation
N/A
Model
N/A
Primary Purpose
N/A
Number of Arms
0
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Tom Heier, James E Caldwell, John R Feiner...
https://pubmed.ncbi.nlm.nih.gov/20808216Impact of reversal strategies on the incidence of postoperative residual paralysis after rocuronium relaxation without neuromuscular monitoring: A partially randomised placebo controlled trial.
Réka Nemes, Béla Fülesdi, Adrienn Pongrácz...
https://pubmed.ncbi.nlm.nih.gov/28030444