Dose Finding Study for Effective Reversal of a Deep Rocuronium-induced Neuromuscular Block With Sugammadex in Morbidly Obese Patients

NCT ID: NCT01911520

Last Updated: 2021-07-13

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

COMPLETED

Clinical Phase

PHASE2

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-01-31

Study Completion Date

2012-06-30

Brief Summary

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During laparoscopic bariatric surgery, adequate muscle relaxation is important to maintain good surgical conditions. To achieve this muscle relaxation, neuromuscular transmission blocking agents, such as rocuronium (Esmeron®) are used. It sometimes happens that there is still some neuromuscular blocking activity left in the patient on awakening from anesthesia. This is called residual curarization and is known to cause postoperative complications such as impairment of respiratory function.

Sugammadex (Bridion®) is a novel drug which selectively binds rocuronium (Esmeron®). It allows for reversing of neuromuscular transmission blocking activity. Until now, all studies with sugammadex were performed in non-obese patients.

Obese patient have a high risk to suffer from post-operative respiratory failure. Therefore it is vital to avoid residual curarization. Sugammadex might be an important factor.

Obese patients have a large total body weight different from ideal body weight. Recent research demonstrated that the dose for the neuromuscular blocking agent rocuronium (Esmeron®) needs to be calculated on the patients' Ideal Body Weight rather than on Total Body Weight.

At this moment no data is available on the dose-response relationship of sugammadex in morbidly obese patients.

We hypothesize that in morbidly obese patients sugammadex should be dosed on ideal bodyweight, instead of total bodyweight.

Detailed Description

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Flowchart :

72 participants

Stratification

BMI\<50 BMI \>50

Randomization Randomization

TBW IBW TBW IBW

2mg/kg n=9 2mg/kg n=9 2mg/kg n=9 2mg/kg n=9 4mg/kg n=9 4mg/kg n=9 4mg/kg n=9 4mg/kg n=9

TBW : Total Body Weight IBW : Ideal Body Weight

Conditions

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Morbidly Obese Patients

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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BMI < 50, Total Body Weight (TBW), 2mg/kg

Patients with a BMI \< 50, who will be dosed according to total body weight.

Group Type EXPERIMENTAL

Sugammadex 2 mg/kg

Intervention Type DRUG

Patients receive 2 mg/kg Sugammadex.

Neuromuscular monitoring.

Intervention Type PROCEDURE

Neuromuscular monitoring using a TOF watch SX (Organon).

Clinical evaluation of residual curarization .

Intervention Type PROCEDURE

Every 30 min, during the first 2 hours after the end of the surgery.

BMI < 50, TBW, 4 mg/kg

Patients with a BMI \< 50, who will be dosed according to total body weight.

Group Type EXPERIMENTAL

Sugammadex. 4 mg/kg

Intervention Type DRUG

Patients receive 4 mg/kg Sugammadex.

Neuromuscular monitoring.

Intervention Type PROCEDURE

Neuromuscular monitoring using a TOF watch SX (Organon).

Clinical evaluation of residual curarization .

Intervention Type PROCEDURE

Every 30 min, during the first 2 hours after the end of the surgery.

BMI < 50, Ideal Body Weight (IBW), 2 mg/kg

Patients with a BMI \< 50, who will be dosed according to ideal body weight.

Group Type EXPERIMENTAL

Sugammadex 2 mg/kg

Intervention Type DRUG

Patients receive 2 mg/kg Sugammadex.

Neuromuscular monitoring.

Intervention Type PROCEDURE

Neuromuscular monitoring using a TOF watch SX (Organon).

Clinical evaluation of residual curarization .

Intervention Type PROCEDURE

Every 30 min, during the first 2 hours after the end of the surgery.

BMI < 50, IBW, 4 mg/kg

Patients with a BMI \< 50, who will be dosed according to ideal body weight.

Group Type EXPERIMENTAL

Sugammadex. 4 mg/kg

Intervention Type DRUG

Patients receive 4 mg/kg Sugammadex.

Neuromuscular monitoring.

Intervention Type PROCEDURE

Neuromuscular monitoring using a TOF watch SX (Organon).

Clinical evaluation of residual curarization .

Intervention Type PROCEDURE

Every 30 min, during the first 2 hours after the end of the surgery.

BMI > 50, TBW, 2mg/kg

Patients with a BMI \> 50, who will be dosed according to total body weight.

Group Type EXPERIMENTAL

Sugammadex 2 mg/kg

Intervention Type DRUG

Patients receive 2 mg/kg Sugammadex.

Neuromuscular monitoring.

Intervention Type PROCEDURE

Neuromuscular monitoring using a TOF watch SX (Organon).

Clinical evaluation of residual curarization .

Intervention Type PROCEDURE

Every 30 min, during the first 2 hours after the end of the surgery.

BMI > 50, TBW, 4mg/kg

Patients with a BMI \> 50, who will be dosed according to total body weight.

Group Type EXPERIMENTAL

Sugammadex. 4 mg/kg

Intervention Type DRUG

Patients receive 4 mg/kg Sugammadex.

Neuromuscular monitoring.

Intervention Type PROCEDURE

Neuromuscular monitoring using a TOF watch SX (Organon).

Clinical evaluation of residual curarization .

Intervention Type PROCEDURE

Every 30 min, during the first 2 hours after the end of the surgery.

BMI >50, IBW, 2 mg/kg

Patients with a BMI \> 50, who will be dosed according to ideal body weight.

Group Type EXPERIMENTAL

Sugammadex 2 mg/kg

Intervention Type DRUG

Patients receive 2 mg/kg Sugammadex.

Neuromuscular monitoring.

Intervention Type PROCEDURE

Neuromuscular monitoring using a TOF watch SX (Organon).

Clinical evaluation of residual curarization .

Intervention Type PROCEDURE

Every 30 min, during the first 2 hours after the end of the surgery.

BMI >50, IBW, 4 mg/kg

Patients with a BMI \> 50, who will be dosed according to ideal body weight.

Group Type EXPERIMENTAL

Sugammadex. 4 mg/kg

Intervention Type DRUG

Patients receive 4 mg/kg Sugammadex.

Neuromuscular monitoring.

Intervention Type PROCEDURE

Neuromuscular monitoring using a TOF watch SX (Organon).

Clinical evaluation of residual curarization .

Intervention Type PROCEDURE

Every 30 min, during the first 2 hours after the end of the surgery.

Interventions

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Sugammadex 2 mg/kg

Patients receive 2 mg/kg Sugammadex.

Intervention Type DRUG

Sugammadex. 4 mg/kg

Patients receive 4 mg/kg Sugammadex.

Intervention Type DRUG

Neuromuscular monitoring.

Neuromuscular monitoring using a TOF watch SX (Organon).

Intervention Type PROCEDURE

Clinical evaluation of residual curarization .

Every 30 min, during the first 2 hours after the end of the surgery.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* ASA I-II-III
* Age 18 - 65 year
* Male or female
* BMI \> 30

Exclusion Criteria

* Renal failure
* Liver dysfunction
* Breastfeeding female patients, or female patients without reliable contraception
* Neuromuscular disease
* Malignant hyperthermia or a family history of malignant hyperthermia
* Allergy for neuromuscular blocking agents or other medications used during general anesthesia
* Infectious disease or patients with fever
* Patients who already received rocuronium or sugammadex on the day of the study
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Ghent

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jurgen Van Limmen, MD

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Ghent

Luc De Baerdemaeker, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Ghent

Koen Reyntjens, MD

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Ghent

Locations

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Ghent University Hospital

Ghent, , Belgium

Site Status

Countries

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Belgium

Related Links

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Other Identifiers

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2009-016857-16

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

2010/207

Identifier Type: -

Identifier Source: org_study_id

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