Can we Antagonize Mivacurium With Neostigmine ?

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

NA

Total Enrollment

80 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-12-31

Study Completion Date

2017-04-22

Brief Summary

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The antagonism of neuromuscular blocking agents (NMBA) (or curares), as well as the antagonism of other drugs used in anesthesia, is a major challenge for the speciality.

Residual paralysis is indeed a risk factor for post-operative morbidity and mortality and antagonization of curares at the end of the procedure is associated with a reduction in mortality .

Its use should be as large as possible and its contraindications are extremely rare.

The antagonism of the NMBA reduces the duration of the neuromuscular block and the complications that are associated .

In this study, the investigators use mivacurium (or Mivacron) as non-depolarizing curare and neostigmine as an antagonist.

Neostigmine reduces the duration of the neuromuscular block induced by mivacurium, By reducing the breakdown of acetylcholine, neostigmine induces an increase in acetylcholine in the synaptic cleft which competes for the same binding site as nondepolarizing neuromuscular blocking agents, and reverses the neuromuscular blockade.

But the use of neostigmine in current practice is not very widespread in this clinical situation.

The reduction in the duration of the block is significant in comparison with a spontaneous recovery .

Moreover, spontaneous recovery is not always complete and sometimes very long.

Nevertheless, its action is effective and this study could support this use but also specify the duration and the quality of the return to normal of the neuromuscular transmission.

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Detailed Description

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Conditions

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Mivacurium Neostigmine Residual Paralysis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

SINGLE

Participants

Study Groups

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GROUP 1

A group receiving neostigmine (40 mcg / kg) when the block Neuromuscular block's recovery measured by acceleromyography is 1 response of 4 in TOF mode (Train Of Four)

Group Type ACTIVE_COMPARATOR

Neostigmine (40 mcg / kg) at different time of neuromuscular block's recovery

Intervention Type DRUG

GROUP 2

A group receiving neostigmine (40 mcg / kg) when the block Neuromuscular block's recovery measured by acceleromyography is 2 response of 4 in TOF mode (Train Of Four)

Group Type ACTIVE_COMPARATOR

Neostigmine (40 mcg / kg) at different time of neuromuscular block's recovery

Intervention Type DRUG

GROUP 3

A group receiving neostigmine (40 mcg / kg) when the block Neuromuscular block's recovery measured by acceleromyography is 3 response of 4 in TOF mode (Train Of Four)

Group Type ACTIVE_COMPARATOR

Neostigmine (40 mcg / kg) at different time of neuromuscular block's recovery

Intervention Type DRUG

GROUP 4

A group receiving neostigmine (40 mcg / kg) when the block Neuromuscular block's recovery measured by acceleromyography is 4 response of 4 in TOF mode (Train Of Four)

Group Type ACTIVE_COMPARATOR

Neostigmine (40 mcg / kg) at different time of neuromuscular block's recovery

Intervention Type DRUG

CONTROL

A control group : not receiving an antagonist (spontaneous recovery)

Group Type ACTIVE_COMPARATOR

Spontaneous recovery

Intervention Type OTHER

just measuring the Train Of Four at 3 6 9 12 and 15 minutes and measure the Train Of Four Ratio

Interventions

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Neostigmine (40 mcg / kg) at different time of neuromuscular block's recovery

Intervention Type DRUG

Spontaneous recovery

just measuring the Train Of Four at 3 6 9 12 and 15 minutes and measure the Train Of Four Ratio

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patients American Society of Anesthesiologists (ASA) 1 to 3
* Absence of neuromuscular disease, renal and hepatic insufficiency
* Absence of medication that could interfere with the mediators of the neuromuscular junction