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

The recruitment status of this study is unknown. The completion date has passed and the status has not been verified in more than two years.
Verified June 2012 by Prokopios Georgiou, University of Patras.
Recruitment status was:  Recruiting
Sponsor:
ClinicalTrials.gov Identifier:
NCT01629394
First Posted: June 27, 2012
Last Update Posted: June 27, 2012
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
Information provided by (Responsible Party):
Prokopios Georgiou, University of Patras
  Purpose
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.

Condition Intervention Phase
Morbid Obesity Neuromuscular Blockade Drug: Sugammadex Drug: Neostigmine Phase 2 Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Treatment
Official Title: Comparative Study of Sugammadex Versus Neostigmine for Reversal of Neuromuscular Blockade in Morbidly Obese Patients Undergoing Weight Loss Surgery.Use of Acceleromyography Monitoring in Adductor Pollicis and Corrugator Supercilii.

Resource links provided by NLM:


Further study details as provided by Prokopios Georgiou, University of Patras:

Primary Outcome Measures:
  • Speed of reversal of neuromuscular blockade after administration of different sugammadex/neostigmine doses to TOF values = 0.9 in adductor pollicis and corrugator supercilii [ Time Frame: TOF values for 2.5 h postoperatively ]

Estimated Enrollment: 120
Study Start Date: January 2012
Estimated Study Completion Date: November 2012
Estimated Primary Completion Date: October 2012 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: 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.
Drug: Sugammadex
Single dose of 2 mg/kg corrected body weight [corrected body weight = ideal body weight + 40%(real body weight - ideal body weight)]
Other Name: Bridion(R)
Active Comparator: 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.
Drug: Sugammadex
Single dose of sugammadex 2 mg/kg ( ideal body weight )
Other Name: Bridion(R)
Active Comparator: 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.
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)]
Active Comparator: 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.
Drug: Neostigmine
Single dose of neostigmine 50 μg/kg ( ideal body weight )
Active Comparator: 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.
Drug: Sugammadex
Single dose of 2 mg/kg corrected body weight [corrected body weight = ideal body weight + 40%( real body weight - ideal body weight)]
Other Name: Bridion(R)
Active Comparator: 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.
Drug: Sugammadex
Single dose of sugammadex 2 mg/kg ( ideal body weight )
Other Name: Bridion(R)
Active Comparator: 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.
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)]
Active Comparator: 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.
Drug: Neostigmine
Single dose of neostigmine 50μg/kg ( ideal body weight )

Detailed Description:

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.

  Eligibility

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 60 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

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
  Contacts and Locations
Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01629394


Contacts
Contact: Prokopios Georgiou, MD 00306973440348 prgeorg@yahoo.gr
Contact: Kriton S. Filos, MD PhD 00302610999341 kritonfilos@yahoo.gr

Locations
Greece
University of Patras, Department of Anesthesiology and Critical Care Medicine Recruiting
Patras, Achaia, Greece, 26500
Contact: Kriton S. Filos, MD PhD    00302610999341    kritonfilos@yahoo.gr   
Sponsors and Collaborators
University of Patras
Investigators
Principal Investigator: Prokopios S. Georgiou, M.D. University Hospital of Patras
Study Chair: Kriton S. Filos, Professor University of Patras, Dept. of Anaesthesiology and Critical Care Medicine
Study Director: Athena Siampalioti, M.D. University Hospital of Patras
  More Information

Responsible Party: Prokopios Georgiou, Prokopios Georgiou M.D., University of Patras
ClinicalTrials.gov Identifier: NCT01629394     History of Changes
Other Study ID Numbers: 952/21-3-12
First Submitted: April 1, 2012
First Posted: June 27, 2012
Last Update Posted: June 27, 2012
Last Verified: June 2012

Additional relevant MeSH terms:
Obesity, Morbid
Obesity
Overnutrition
Nutrition Disorders
Overweight
Body Weight
Signs and Symptoms
Neostigmine
Cholinesterase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Cholinergic Agents
Neurotransmitter Agents
Physiological Effects of Drugs
Parasympathomimetics
Autonomic Agents
Peripheral Nervous System Agents