Comparative Study of Sugammadex Versus Neostigmine for Reversal of Neuromuscular Blockade in Morbidly Obese Patients

NCT ID: NCT01629394

Last Updated: 2012-06-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE2/PHASE3

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-01-31

Study Completion Date

2012-11-30

Brief Summary

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Postoperative residual curarization in the post anaesthesia unit has been associated to complications involving respiratory function and impaired laryngeal and pharyngeal muscles' function. Speed of reversal of neuromuscular blockade after administration of sugammadex versus neostigmine has been studied, but up to date no data are available concerning continuous acceleromyography monitoring of adductor pollicis and corrugator supercilii in morbidly obese patients undergoing weight loss surgery. The investigators' aim in this prospective, double-blinded study was to compare train of four ( TOF ) values, the presence or absence of clinical criteria of postoperative residual curarization , the dose requirements and the side effects of sugammadex and neostigmine for the reversal of rocuronium induced neuromuscular blockade in patients undergoing laparoscopic or open surgery for morbid obesity.

Detailed Description

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Morbidly obese patients \[ body mass index (BMI) \> 40 kg/m2 \] planned to undergo open or laparoscopic surgery for weight loss will be managed with standardized general anesthesia (intravenous Propofol combined with remifentanil and muscle relaxation induced by rocuronium).

By the end of the surgery, Group A and group E patients will receive sugammadex 2 mg/kg corrected body weight \[corrected body weight(CBW)=ideal body weight(IBW) + 40%(real body weight(RBW)-ideal body weight)\] when T2 arises in adductor pollicis. Group C and group G will receive neostigmine 50μg/kg corrected body weight when T2 arises in adductor pollicis. Group B and group F patients will receive sugammadex 2 mg/kg ideal body weight when T2 arises in adductor pollicis. Group D and group H patients will receive 50μg/kg neostigmine ideal body weight.

Investigators will proceed in continuous acceleromyography monitoring of adductor pollicis and corrugator supercilii during induction of anaesthesia, surgery, recovery and in the post anaesthesia care unit, recording TOF values. Total consumption of neuromuscular blocking agent, doses of reversal agents and clinical criteria of post operation residual curarization will also be recorded.

Conditions

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Morbid Obesity Neuromuscular Blockade

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Group A: Sugammadex CBW-open

Group A patients will undergo open surgery and will receive sugammadex 2mg/kg corrected body weight \[corrected body weight = ideal body weight + 40%( real body weight - ideal body weight)\] when T2 arises in adductor pollicis.

Group Type ACTIVE_COMPARATOR

Sugammadex

Intervention Type DRUG

Single dose of 2 mg/kg corrected body weight \[corrected body weight = ideal body weight + 40%(real body weight - ideal body weight)\]

Group B: Sugammadex IBW-open

Group B patients will undergo open surgery and will receive sugammadex 2mg/kg ( ideal body weight ) when T2 arises in adductor pollicis.

Group Type ACTIVE_COMPARATOR

Sugammadex

Intervention Type DRUG

Single dose of sugammadex 2 mg/kg ( ideal body weight )

Group C: Neostigmine CBW-open

Group C patients will undergo open surgery and will receive neostigmine 50μg/kg corrected body weight \[corrected body weight = ideal body weight + 40%(real body weight - ideal body weight)\]when T2 arises in adductor pollicis.

Group Type ACTIVE_COMPARATOR

Neostigmine

Intervention Type DRUG

Single dose of neostigmine 50 μg/kg corrected body weight \[corrected body weight = ideal body weight + 40%(real body weight - ideal body weight)\]

Group D: Neostigmine-IBW

Group D patients will undergo open surgery and will receive neostigmine 50μg/kg ( ideal body weight ) when T2 arises in adductor pollicis.

Group Type ACTIVE_COMPARATOR

Neostigmine

Intervention Type DRUG

Single dose of neostigmine 50 μg/kg ( ideal body weight )

Group E: Sugammadex CBW-Lap

Group E patients will undergo laparoscopic surgery and will receive sugammadex 2mg/kg corrected body weight \[corrected body weight = ideal body weight + 40%( real body weight - ideal body weight)\] when T2 arises in adductor pollicis.

Group Type ACTIVE_COMPARATOR

Sugammadex

Intervention Type DRUG

Single dose of 2 mg/kg corrected body weight \[corrected body weight = ideal body weight + 40%( real body weight - ideal body weight)\]

Group F: Sugammadex IBW-Lap

Group F patients will undergo laparoscopic surgery and will receive sugammadex 2mg/kg ( ideal body weight ) when T2 arises in adductor pollicis.

Group Type ACTIVE_COMPARATOR

Sugammadex

Intervention Type DRUG

Single dose of sugammadex 2 mg/kg ( ideal body weight )

Group G: Neostigmine CBW-Lap

Group C patients will undergo laparoscopic surgery and will receive neostigmine 50μg/kg corrected body weight \[corrected body weight = ideal body weight + 40%(real body weight - ideal body weight)\]when T2 arises in adductor pollicis.

Group Type ACTIVE_COMPARATOR

Neostigmine

Intervention Type DRUG

Single dose of neostigmine 50 μg/kg corrected body weight \[corrected body weight = ideal body weight + 40%(real body weight - ideal body weight)\]

Group H: Neostigmine IBW-Lap

Group D patients will undergo open surgery and will receive neostigmine 50μg/kg ( ideal body weight ) when T2 arises in adductor pollicis.

Group Type ACTIVE_COMPARATOR

Neostigmine

Intervention Type DRUG

Single dose of neostigmine 50μg/kg ( ideal body weight )

Interventions

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Sugammadex

Single dose of 2 mg/kg corrected body weight \[corrected body weight = ideal body weight + 40%(real body weight - ideal body weight)\]

Intervention Type DRUG

Sugammadex

Single dose of sugammadex 2 mg/kg ( ideal body weight )

Intervention Type DRUG

Neostigmine

Single dose of neostigmine 50 μg/kg corrected body weight \[corrected body weight = ideal body weight + 40%(real body weight - ideal body weight)\]

Intervention Type DRUG

Neostigmine

Single dose of neostigmine 50 μg/kg ( ideal body weight )

Intervention Type DRUG

Sugammadex

Single dose of 2 mg/kg corrected body weight \[corrected body weight = ideal body weight + 40%( real body weight - ideal body weight)\]

Intervention Type DRUG

Sugammadex

Single dose of sugammadex 2 mg/kg ( ideal body weight )

Intervention Type DRUG

Neostigmine

Single dose of neostigmine 50 μg/kg corrected body weight \[corrected body weight = ideal body weight + 40%(real body weight - ideal body weight)\]

Intervention Type DRUG

Neostigmine

Single dose of neostigmine 50μg/kg ( ideal body weight )

Intervention Type DRUG

Other Intervention Names

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Bridion(R) Bridion(R) Bridion(R) Bridion(R)

Eligibility Criteria

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Inclusion Criteria

* Body mass index (BMI) \>40kg
* Age \< 60
* Patients written consent to participate in the study

Exclusion Criteria

* Cardiovascular disease (NYHA\>2)
* Patients refusal to participate in the study
* Contraindication to epidural catheter placement (e.g anticoagulation, anti- platelets medication)
* coexisting neuromuscular disease
* history of allergic reaction to neuromuscular blocking agents
* history of difficult intubation
* creatinine levels \> 159lmol/l
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Patras

OTHER

Sponsor Role lead

Responsible Party

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Prokopios Georgiou

Prokopios Georgiou M.D.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Prokopios S. Georgiou, M.D.

Role: PRINCIPAL_INVESTIGATOR

University Hospital of Patras

Kriton S. Filos, Professor

Role: STUDY_CHAIR

University of Patras, Dept. of Anaesthesiology and Critical Care Medicine

Athena Siampalioti, M.D.

Role: STUDY_DIRECTOR

University Hospital of Patras

Locations

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University of Patras, Department of Anesthesiology and Critical Care Medicine

Pátrai, Achaia, Greece

Site Status RECRUITING

Countries

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Greece

Central Contacts

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Prokopios Georgiou, MD

Role: CONTACT

00306973440348

Kriton S. Filos, MD PhD

Role: CONTACT

00302610999341

Facility Contacts

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Kriton S. Filos, MD PhD

Role: primary

00302610999341

Other Identifiers

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952/21-3-12

Identifier Type: -

Identifier Source: org_study_id

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