Sarcopenia and Neuromuscular Block in Gastrointestinal Cancer Surgery

NCT07003061 | Completed

• 1 other identifier: 2025-05/79
• Study Type: observational
• Target: 100
• Locations: 1 country
• Sites: 1

Brief Summary

This prospective observational study aims to evaluate the effects of sarcopenia on intraoperative neuromuscular block (NMB) in patients undergoing gastrointestinal cancer surgery. Adult patients scheduled for elective gastrointestinal cancer surgery will be grouped as sarcopenic or non-sarcopenic based on preoperative abdominal CT scans. Neuromuscular block parameters, including onset time, depth, duration, and recovery, will be objectively measured using TOF (Train-of-Four) monitoring. The study seeks to determine whether sarcopenia influences sensitivity to muscle relaxants and to contribute to individualized anesthesia management and patient safety.

Conditions

Sarcopenia; Neuromuscular Blockade; Gastrointestinal Cancer

Outcome Measures

Primary Outcomes (4)

• Onset Time of Neuromuscular Block

  Time from administration of the muscle relaxant to achievement of adequate neuromuscular block, measured by Train-of-Four (TOF) monitoring.

  Intraoperative (from induction until adequate block is achieved)

• Depth of Neuromuscular Block (TOF Ratio)

  Intraoperative depth of neuromuscular block, continuously monitored using TOF ratio.

  Intraoperative (from induction to end of surgery)

• Duration of Neuromuscular Block

  Time from administration of the muscle relaxant to recovery of neuromuscular function (TOF ratio ≥ 0.9).

  Intraoperative (from muscle relaxant administration to recovery)

• Dose and Duration of Reversal Agent

  Total dose and time required for the reversal agent to achieve recovery from neuromuscular block.

  Intraoperative (from administration of reversal agent to recovery)

Study Arms (2)

Sarcopenic

Patients with gastrointestinal cancer scheduled for elective surgery who are identified as sarcopenic based on preoperative abdominal CT scans at the L3 vertebral level, according to established cut-off values.

Procedure: Standard Anesthesia Management

Non-Sarcopenic

Patients with gastrointestinal cancer scheduled for elective surgery who are identified as non-sarcopenic based on preoperative abdominal CT scans at the L3 vertebral level, according to established cut-off values.

Procedure: Standard Anesthesia Management

Interventions

Standard Anesthesia Management PROCEDURE

All patients will receive standard anesthesia care as per institutional protocols. No experimental intervention will be applied.

Non-Sarcopenic; Sarcopenic

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Adult patients aged 18 to 75 years who have been diagnosed with gastrointestinal cancer and are scheduled for elective surgery at Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital. All participants will have undergone preoperative abdominal CT scans. Both male and female patients meeting the inclusion and exclusion criteria will be eligible for enrollment.

You may qualify if:

• Patients aged between 18 and 75 years
• Patients diagnosed with gastrointestinal system (GIS) cancer and scheduled for elective surgery
• Patients who have undergone preoperative abdominal computed tomography (CT) imaging
• Patients classified as American Society of Anesthesiologists (ASA) physical status I-III

You may not qualify if:

• Patients with a history of neuromuscular diseases
• Patients receiving chronic steroid or immunosuppressive therapy
• Patients with electrolyte imbalance
• Patients using medications that affect neuromuscular transmission
• Patients with severe organ failure in the preoperative period (e.g., liver or renal failure)
• Patients who refuse to participate in the study
• Patients requiring emergency surgery
• Patients using muscle relaxants in the preoperative period

Sponsors & Collaborators

• Dr Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital: lead

Study Sites (1)

Dr. Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital Clinic of Anesthesiology and Rea

Ankara, Yenimahalle, 06200, Turkey (Türkiye)

Location

Related Publications (2)

• Almeida PS, Barao K, Forones NM. SARCOPENIA AND GASTROINTESTINAL CANCER: NUTRITIONAL APPROACH FOCUSING ON CURCUMIN SUPPLEMENTATION. Arq Gastroenterol. 2025 Apr 4;62:e24068. doi: 10.1590/S0004-2803.24612024-068. eCollection 2025.

  PMID: 40197883 BACKGROUND

• Clark BC. Neuromuscular Changes with Aging and Sarcopenia. J Frailty Aging. 2019;8(1):7-9. doi: 10.14283/jfa.2018.35.

  PMID: 30734824 BACKGROUND

MeSH Terms

Conditions

Gastrointestinal Neoplasms; Sarcopenia

Condition Hierarchy (Ancestors)

Digestive System Neoplasms; Neoplasms by Site; Neoplasms; Digestive System Diseases; Gastrointestinal Diseases; Muscular Atrophy; Neuromuscular Manifestations; Neurologic Manifestations; Nervous System Diseases; Atrophy; Pathological Conditions, Anatomical; Pathological Conditions, Signs and Symptoms; Signs and Symptoms

Study Officials

• Mustafa Kemal SAHIN

  Ankara Oncology Education and Research Hospital Clinic of Anesthesiology and Reanimation

  PRINCIPAL INVESTIGATOR

• Mensure KAYA

  Ankara Oncology Education and Research Hospital Clinic of Anesthesiology and Reanimation

  PRINCIPAL INVESTIGATOR

• Belkis YILMAZ

  Ankara Oncology Education and Research Hospital Clinic of Anesthesiology and Reanimation

  PRINCIPAL INVESTIGATOR

• Ahmet BAYRAK

  Ankara Oncology Education and Research Hospital Clinic of Radiology

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: May 26, 2025
• First Posted: June 4, 2025
• Study Start: June 1, 2025
• Primary Completion: February 10, 2026
• Study Completion: April 1, 2026
• Last Updated: April 30, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)