Residual Block in Postoperative Anaesthetic Care Unit

NCT02930629 | Unknown

• 2 other identifiers: 1607 PACU residual block2016/2478
• Study Type: observational
• Target: 400
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to assess the incidence of residual block in patients arriving in the Post Anaesthetic Care Unit (PACU) following surgery, and in those who have received neuromuscular blocking drugs (muscle relaxants). Residual block (decreased motor function) due to residual levels of muscle relaxants is associated with increased morbidity.

Conditions

Neuromuscular Blockade

Keywords

Recovery Period, Anesthesia; Neuromuscular Monitoring

Outcome Measures

Primary Outcomes (1)

• Evidence of residual block (train of four <0.9) after receiving neuromuscular block for anaesthesia for surgery

  Train of four is measured at the adductor pollicis using TOF Watch acceleromyography

  Within one hour of surgery

Interventions

Train-of-Four (TOF) Watch DEVICE

For patients, on arriving in PACU after having had muscle relaxants during general anaesthesia * Two ECG electrodes will be placed 4 cm apart over the path of the ulnar nerve of the wrist after cleaning the skin with alcohol swabs. * The TOF force transducer will be placed on the volar aspect of the thumb. * The TOF Watch leads will be attached to the ECG electrodes. * A TOF stimulus will be applied: four twitches at 2Hz (every 0.5 seconds), each twitch lasting 0.2ms, and at a current of 50 mA. As far as possible, this will be done when patients are still slightly drowsy from the effects of anaesthesia. * Two TOF ratio will be elicited (two sets of four twitches 15 seconds apart), and an average of the two taken

Eligibility Criteria

• Age: 21 Years - 99 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All patients 21 years old or older, who receive neuromuscular blocking drugs (muscle relaxants) as part of their anaesthesia for surgery, and who arrive in the postoperative anaesthesia care unit.

You may qualify if:

• All patients 21 years old or older, who receive neuromuscular blocking drugs (muscle relaxants) as part of their anaesthesia for surgery.

You may not qualify if:

• Patients who have neuromuscular disease
• Patients for whom applying train-of-four (to detect residual block) monitoring on their ulnar nerves is not possible

Sponsors & Collaborators

• Singapore General Hospital: lead

Study Sites (1)

Singapore General Hospital

Singapore, 169608, Singapore

RECRUITING

Related Publications (2)

• Plaud B, Debaene B, Donati F, Marty J. Residual paralysis after emergence from anesthesia. Anesthesiology. 2010 Apr;112(4):1013-22. doi: 10.1097/ALN.0b013e3181cded07. No abstract available.

  PMID: 20234315 RESULT

• Brull SJ, Prielipp RC. Reversal of neuromuscular blockade: "identification friend or foe". Anesthesiology. 2015 Jun;122(6):1183-5. doi: 10.1097/ALN.0000000000000675. No abstract available.

  PMID: 25856292 RESULT

Study Officials

• Patrick Wong, MBBS FRCA

  Singapore General Hospital

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Patrick Wong, MBBS FRCA

CONTACT

+6563214220; patrick.wong@singhealth.com.sg

Ruban Poopalalingam, MBBS MMED

CONTACT

+6563214220; Ruban.Poopalalingam@singhealth.com.sg

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: October 10, 2016
• First Posted: October 12, 2016
• Study Start: October 1, 2016
• Primary Completion: August 18, 2017
• Study Completion: August 18, 2017
• Last Updated: May 1, 2017

Record last verified: 2017-04

Data Sharing

• IPD Sharing: Will not share

Locations

SG (1)