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Rocuronium vs Cis-atracurium: Do Rocuronium Still 'ROCKS' In Coronary Artery Bypass Grafting

NCT ID: NCT06102915

Last Updated: 2023-11-28

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

Total Enrollment

289 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-08-01

Study Completion Date

2023-11-23

Brief Summary

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The current trend in most cardiac surgeries was to use rocuronium as it provides faster recovery in train-of-four ratio compared to other aminosteroid non-depolarising neuromuscular blocker. However, as most cardiac centres' standard of care does not perform any neuromuscular monitoring nor antagonism of neuromuscular blockade effect, residual neuromuscular blockade could potentially be the key to delayed extubation. As such, Cis-atracurium's organ-independent Hofmann elimination could be in favour.

Detailed Description

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Conditions

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Neuromuscular Blockade Postoperative Pulmonary Atelectasis Postoperative Pulmonary Complication Coronary Artery Disease Coronary Artery Bypass Grafting Hypothermic Cardiopulmonary Bypass

Study Design

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Observational Model Type

COHORT

Study Time Perspective

RETROSPECTIVE

Study Groups

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Rocuronium

Rocuronium 1mg/kg to be given at induction of anaesthesia and another 1mg/kg would be given when the patient is on hypothermic cardiopulmonary bypass

Rocuronium Bromide 10 MG/ML

Intervention Type DRUG

Comparative

Cis-atracurium

Cis-atracurium 0.2mg/kg to be given at induction of anaesthesia and another 0.2mg/kg would be given when the patient is on hypothermic cardiopulmonary bypass

Nimbex 10 MG in 5 ML Injection

Intervention Type DRUG

Comparative

Interventions

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Rocuronium Bromide 10 MG/ML

Comparative

Intervention Type DRUG

Nimbex 10 MG in 5 ML Injection

Comparative

Intervention Type DRUG

Other Intervention Names

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Esmeron Cis-atracurium

Eligibility Criteria

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Inclusion Criteria

* All patients that undergo general anaesthesia for CABG surgery requiring neuromuscular blockade of either rocuronium or cis-atracurium

Exclusion Criteria

1. Recent history of pulmonary infection four weeks before surgery
2. Exposed to both neuromuscular blockade within 24 hours perioperatively
3. Patients intubated or on tracheostomies pre-operatively
4. Any missing or incomplete data
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Institut Jantung Negara

OTHER

Sponsor Role lead

Responsible Party

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SONG LIN LOW

Dr

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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SONG LIN LOW, MBBS

Role: PRINCIPAL_INVESTIGATOR

IJN

Locations

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Institut Jantung Negara

Kuala Lumpur, , Malaysia

Site Status

Countries

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Malaysia

References

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Thomas R, Smith D, Strike P. Prospective randomised double-blind comparative study of rocuronium and pancuronium in adult patients scheduled for elective 'fast-track' cardiac surgery involving hypothermic cardiopulmonary bypass. Anaesthesia. 2003 Mar;58(3):265-71. doi: 10.1046/j.1365-2044.2003.30362.x.

Reference Type RESULT
PMID: 12638566 (View on PubMed)

Hemmerling TM, Russo G, Bracco D. Neuromuscular blockade in cardiac surgery: an update for clinicians. Ann Card Anaesth. 2008 Jul-Dec;11(2):80-90. doi: 10.4103/0971-9784.41575.

Reference Type RESULT
PMID: 18603747 (View on PubMed)

Murphy GS, Szokol JW, Vender JS, Marymont JH, Avram MJ. The use of neuromuscular blocking drugs in adult cardiac surgery: results of a national postal survey. Anesth Analg. 2002 Dec;95(6):1534-9, table of contents. doi: 10.1097/00000539-200212000-00012.

Reference Type RESULT
PMID: 12456412 (View on PubMed)

Naguib M, Samarkandi AH, Ammar A, Elfaqih SR, Al-Zahrani S, Turkistani A. Comparative clinical pharmacology of rocuronium, cisatracurium, and their combination. Anesthesiology. 1998 Nov;89(5):1116-24. doi: 10.1097/00000542-199811000-00011.

Reference Type RESULT
PMID: 9821999 (View on PubMed)

Miskovic A, Lumb AB. Postoperative pulmonary complications. Br J Anaesth. 2017 Mar 1;118(3):317-334. doi: 10.1093/bja/aex002.

Reference Type RESULT
PMID: 28186222 (View on PubMed)

Other Identifiers

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IJNREC/631/2023

Identifier Type: -

Identifier Source: org_study_id