NCT03138967

Brief Summary

The goal of this clinical research study is to determine whether using sugammadex, given with a standard muscle relaxation drug during bladder surgeries, improves anesthesia conditions and recovery time. During some bladder operations, your muscles must be completely relaxed. Muscle relaxation drugs cause the muscles to relax, including the respiratory muscles, and as a result artificial ventilation is needed to help you breathe. Sugammadex and other standard drugs reverse the effect of the muscle relaxation drugs, allowing you to breathe on your own after the operation. Study Groups: If you agree to take part in this study, you will be randomly assigned (as in the flip of a coin) to 1 of 2 study groups. This is done because no one knows if one study group is better, the same, or worse than the other group:

  • If you are in Group 1, you will receive sugammadex to reverse the muscle relaxation.
  • If you are in Group 2, you will receive the standard of care (neostigmine/glycopyrrolate) to reverse the muscle relaxation. You and the surgeon will not know which group you have been assigned to. However, the anesthesiologist and study staff will know. Length of Study: You will be on study for up to 1 week after the cystoscopy. If you are unable to have the procedure performed, you may be taken off study early. This is an investigational study. Sugammadex and neostigmine/glycopyrrolate are all FDA approved and commercially available to reverse muscle relaxation. The comparison of these drugs is investigational. Up to 50 participants will take part in this study. All will be enrolled at MD Anderson.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
54

participants targeted

Target at P25-P50 for phase_4

Timeline
Completed

Started Sep 2017

Typical duration for phase_4

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

May 1, 2017

Completed
2 days until next milestone

First Posted

Study publicly available on registry

May 3, 2017

Completed
5 months until next milestone

Study Start

First participant enrolled

September 18, 2017

Completed
12 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 1, 2018

Completed
11 months until next milestone

Results Posted

Study results publicly available

July 26, 2019

Completed
4 months until next milestone

Study Completion

Last participant's last visit for all outcomes

November 24, 2019

Completed
Last Updated

September 22, 2020

Status Verified

September 1, 2020

Enrollment Period

12 months

First QC Date

May 1, 2017

Results QC Date

June 27, 2019

Last Update Submit

September 2, 2020

Conditions

Keywords

Malignant neoplasms of urinary tractBladder cancerOutpatient bladder proceduresOutpatient cystoscopy procedureTransurethral resection of the bladderTURBRocuroniumRocuronium BromideZemuronSugammadexNeostigmineGlycopyrrolate

Outcome Measures

Primary Outcomes (1)

  • Muscle Recovery Time

    The primary outcome is to determine if Sugammadex can improve muscle recovery time, measured by time from administration of neuromuscular blockade reversal to train-of-four ratio of 0.9 in outpatient bladder procedures. It was assessed in the intraoperative period measuring the time from administration of reversal agent to TOF of 0.9 in minutes.

    Intraoperatively, up to 3 hours

Secondary Outcomes (2)

  • PostOperative Complications

    Post-operatively, up to 7 days

  • Overall Recovery Time

    Up to 3 hours after end of surgery

Study Arms (2)

Sugammadex

EXPERIMENTAL

Participants to have cystoscopy with bladder tumor resection. Rocuronium used to induce the neuromuscular blockade and given in a rapid sequence for endotracheal intubation at a dose of 0.45 mg/kg of Ideal Body Weight. If maintenance is needed for continued relaxation then a dose of 0.15 mg/kg of Ideal Body Weight repeated as necessary. Sugammadex administered as a single bolus, intravenous injection. The amount used is based on the patient's weight. A dose of 4 mg/kg used if recovery has reached at least 1-2 post-tetanic counts (PTC) following Rocuronium induced blockade.

Drug: RocuroniumDrug: Sugammadex

Standard of Care - Neostigmine/Glycopyrrolate

ACTIVE COMPARATOR

Participants to have cystoscopy with bladder tumor resection. Rocuronium used to induce the neuromuscular blockade and given in a rapid sequence for endotracheal intubation at a dose of 0.45 mg/kg of Ideal Body Weight. If maintenance is needed for continued relaxation then a dose of 0.15 mg/kg of Ideal Body Weight repeated as necessary. Neostigmine/Glycopyrrolate administered as a single bolus, intravenous injection. The amount used is based on the patient's weight. Once T1 is at 10% or greater, a dose of 70 mcg/kg of Neostigmine with 14 mcg/kg Glycopyrrolate administered simultaneously over a period of one minute up to 5 mg.

Drug: RocuroniumDrug: NeostigmineDrug: Glycopyrrolate

Interventions

Experimental: Sugammadex Participants to have cystoscopy with bladder tumor resection. Rocuronium used to induce the neuromuscular blockade and given in a rapid sequence for endotracheal intubation at a dose of 0.45 mg/kg of Ideal Body Weight. If maintenance is needed for continued relaxation then a dose of 0.15 mg/kg of Ideal Body Weight repeated as necessary.

Also known as: Rocuronium Bromide, Zemuron
Standard of Care - Neostigmine/GlycopyrrolateSugammadex

Sugammadex administered as a single bolus, intravenous injection. The amount used is based on the patient's weight. A dose of 4 mg/kg used if recovery has reached at least 1-2 post-tetanic counts (PTC) following Rocuronium induced blockade.

Sugammadex

70 mcg/kg by vein to reverse the muscle relaxation.

Standard of Care - Neostigmine/Glycopyrrolate

14 mcg/kg by vein to reverse the muscle relaxation.

Standard of Care - Neostigmine/Glycopyrrolate

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Is scheduled to undergo cystoscopy with bladder resection procedure under general anesthesia requiring neuromuscular relaxation using rocuronium bromide to secure airway and requiring neuromuscular reversal at The University of Texas MD Anderson Cancer Center - Mays Clinic (ACB-outpatient)
  • Male or Females who are \>= 18 years of age
  • Classified by the American Society of Anesthesiologists (ASA) as Class I - IV
  • Candidate for use of laryngeal mask airway (LMA)
  • Able to give consent

You may not qualify if:

  • Severe renal impairment as measured eGFR less than 30 per institutional laboratory.
  • Females who are pregnant or might be pregnant or are breast-feeding.
  • Females who have been diagnosed with breast cancer and currently taking Toremifene
  • Is known or suspected to have significant hepatic dysfunction, with AST \& ALT 3 times above UNL per institutional laboratory.
  • Is known or suspected to have a (family) history of malignant hyperthermia
  • Is known or suspected to have an allergy to opioids, muscle relaxants or other medications used during general anesthesia
  • Is known or suspected to have neuromuscular disorders (ex: myasthenia gravis)

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

University of Texas MD Anderson Cancer Center

Houston, Texas, 77030, United States

Location

Related Links

MeSH Terms

Conditions

Urologic NeoplasmsUrinary Bladder Neoplasms

Interventions

RocuroniumSugammadexNeostigmineGlycopyrrolate

Condition Hierarchy (Ancestors)

Urogenital NeoplasmsNeoplasms by SiteNeoplasmsFemale Urogenital DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesMale Urogenital DiseasesUrologic DiseasesUrinary Bladder Diseases

Intervention Hierarchy (Ancestors)

AndrostanolsAndrostanesSteroidsFused-Ring CompoundsPolycyclic Compoundsgamma-CyclodextrinsCyclodextrinsMacrocyclic CompoundsDextrinsStarchGlucansPolysaccharidesCarbohydratesPhenylammonium CompoundsQuaternary Ammonium CompoundsAminesOrganic ChemicalsOnium CompoundsPyrrolidinesHeterocyclic Compounds, 1-RingHeterocyclic Compounds

Results Point of Contact

Title
Dr. Farzin Goravanchi / Anesthesiology & Perioperative Medicine
Organization
UT MD Anderson Cancer Center

Study Officials

  • Farzin Goravanchi, DO

    M.D. Anderson Cancer Center

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
Yes

Study Design

Study Type
interventional
Phase
phase 4
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
PARTICIPANT, INVESTIGATOR
Purpose
SUPPORTIVE CARE
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

May 1, 2017

First Posted

May 3, 2017

Study Start

September 18, 2017

Primary Completion

September 1, 2018

Study Completion

November 24, 2019

Last Updated

September 22, 2020

Results First Posted

July 26, 2019

Record last verified: 2020-09

Locations