Effects of Neostigmine-dose on Diaphragmatic Dynamics

NCT ID: NCT06787638

Last Updated: 2025-01-22

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

NOT_YET_RECRUITING

Clinical Phase

PHASE1

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-01-25

Study Completion Date

2026-04-30

Brief Summary

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The goal of this Randomized Clinical Trial is to compare the postoperative diaphragmatic excursion between patients receiving half-dose neostigmine (0.04 mg/kg) and those receiving full-dose neostigmine (0.08 mg/kg) for neuromuscular blockade reversal.

The main questions it aims to answer are:

* Does half-dose neostigmine result in similar postoperative diaphragmatic excursion compared to full-dose neostigmine?
* Does half-dose neostigmine result in similar diaphragmatic thickening fraction compared to full-dose neostigmine? Researchers will compare patients receiving half-dose neostigmine to those receiving full-dose neostigmine to see if there are differences in postoperative diaphragmatic function, respiratory complications, and recovery.

Participants will:

* Undergo elective laparoscopic cholecystectomy.
* Receive either half-dose or full-dose neostigmine for neuromuscular blockade reversal.

Detailed Description

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Fifty patients from both genders scheduled for elective laparoscopic cholecystectomy were enrolled in this study to compare diaphragmatic assessment parameters.

Enrolled participants were randomly assigned to group A (patient receiving full dose of Neostigmine (0.08 mg/kg) plus Atropine (20 mic/kg)) or group B (patient receiving half dose of Neostigmine (0.04 mg/kg) plus Atropine (20 mic/kg)).

This is a prospective study that will be conducted at Aswan University Hospital.

Eligible participants will be adult patients (age ≥ 18 years) scheduled for elective laparoscopic cholecystectomy, with American Society of Anesthesiologists (ASA) physical status I or II, and a body mass index (BMI) \< 35 kg/m². Patients with pre-existing diaphragmatic or respiratory disorders, ASA physical status III or IV, BMI \> 35 kg/m², chronic opioid use or abuse, pregnancy, or breastfeeding will be excluded.

Conditions

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Diaphragm Ultrasound

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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full dose of Neostigmine

Group Type ACTIVE_COMPARATOR

full dose of Neostigmine

Intervention Type DRUG

• Group A: received 10ml (a full dose of Neostigmine (0.08 mg/kg) plus Atropine (20 mic/kg+7ml normal saline)

Measured using ultrasound Time frame: preoperatively and at zero, 10 minutes and 30 minutes postoperatively.

half dose of Neostigmine

Group Type ACTIVE_COMPARATOR

half dose of Neostigmine

Intervention Type DRUG

• Group B: received 10ml (a half dose of Neostigmine (0.04 mg/kg) plus Atropine (20 mic/kg+8ml normal saline).

Measured using ultrasound Time frame: preoperatively and at zero, 10 minutes and 30 minutes postoperatively.

Interventions

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full dose of Neostigmine

• Group A: received 10ml (a full dose of Neostigmine (0.08 mg/kg) plus Atropine (20 mic/kg+7ml normal saline)

Measured using ultrasound Time frame: preoperatively and at zero, 10 minutes and 30 minutes postoperatively.

Intervention Type DRUG

half dose of Neostigmine

• Group B: received 10ml (a half dose of Neostigmine (0.04 mg/kg) plus Atropine (20 mic/kg+8ml normal saline).

Measured using ultrasound Time frame: preoperatively and at zero, 10 minutes and 30 minutes postoperatively.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Adults scheduled for elective laparoscopic cholecystectomy.
* Age: \< or = 18 years.
* Both genders.
* American Society Of Anesthiologists (ASA) I/II patients.
* BMI \<35

Exclusion Criteria

* Pre-existing diaphragmatic or respiratory disorders.
* ASA III/IV
* BMI \>35
* Chronic opioid use or abuse
* Pregnancy or breastfeeding
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Aswan University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Sara Abd El Dayem Mohamed Abed

Resident of anesthesia, surgical intensive care & pain management

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ayman M El-demirdash

Role: STUDY_CHAIR

Anesthesia, surgical intensive care and pain management - Aswan University Hospital

Hani M Raslan

Role: STUDY_DIRECTOR

Anesthesia, surgical intensive care and pain management - Aswan University Hospital

Zaher Z Zaher

Role: STUDY_DIRECTOR

Anesthesia, surgical intensive care and pain management - Aswan University Hospital

Central Contacts

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Sara A Mohamed

Role: CONTACT

+201153006436

References

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Ayoub J, Cohendy R, Prioux J, Ahmaidi S, Bourgeois JM, Dauzat M, Ramonatxo M, Prefaut C. Diaphragm movement before and after cholecystectomy: a sonographic study. Anesth Analg. 2001 Mar;92(3):755-61. doi: 10.1097/00000539-200103000-00038.

Reference Type BACKGROUND
PMID: 11226114 (View on PubMed)

Alam MJ, Roy S, Iktidar MA, Padma FK, Nipun KI, Chowdhury S, Nath RK, Rashid HO. Diaphragm ultrasound as a better predictor of successful extubation from mechanical ventilation than rapid shallow breathing index. Acute Crit Care. 2022 Feb;37(1):94-100. doi: 10.4266/acc.2021.01354. Epub 2022 Jan 11.

Reference Type BACKGROUND
PMID: 35081706 (View on PubMed)

Adeyinka A, Layer DA. Neuromuscular Blocking Agents. 2024 Jun 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from http://www.ncbi.nlm.nih.gov/books/NBK537168/

Reference Type BACKGROUND
PMID: 30725853 (View on PubMed)

Other Identifiers

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944/7/24

Identifier Type: -

Identifier Source: org_study_id

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