Neuromuscular Blockade
Conditions
Brief summary
Neuromuscular block improves operation conditions during laparoscopic surgery. In this study, a new measurement tool is assessed: the degree of abdominal distension during the time course of the neuromuscular block is measured and compared with a standardized score (surgical rating score).
Interventions
OTHERmeasuring tape
measurement of change in abdominal wall length \[cm\] during neuromuscular block with a measuring tape.
OTHERneuromuscular block
Measurement of the time course of the neuromuscular block: neuromuscular transmission is measured by assessment of the post tetanic count and the train of four ratio using acceleromyography (TOF Watch SX™, Essex Pharma GmbH, Munich, Germany) at the right adductor pollicis muscle with transcutaneous Ag/AgCl electrodes (electrocardiogram electrodes; Ambu Inc., MD 21060 USA);
OTHERSurgical rating score
assessment of operating conditions by means of a standardized score: surgical rating score: 1. extremely poor conditions 2. poor conditions 3. acceptable conditions 4. good conditions 5. optimal conditions
Sponsors
Kreiskrankenhaus Dormagen
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Masking description
Assessment of the quality of operation conditions by the obstretic surgeon without information with regard to the actual depth of the neuromuscular block or the drugs administrated for improvement of the block.
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 99 Years
Healthy volunteers
No
Inclusion criteria
* laparoscopic gynecologic surgery * American Society of Anesthesiologists Physical Status ASA 1-2
Exclusion criteria
* anticipated difficult airway * increased risk for pulmonary aspiration * acute infection * pregnancy * impaired liver- oder kidney function * neuromuscular disease * chronic intake of drugs known to influence neuromuscular blockade
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| change in abdominal wall length (cm) during time course of the block | during operation | Changes in abdominal wall length are measured during the time course of the neuromuscular block every 15 min. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change of surgical Rating scale (SRS) scores during neuromuscular block | during operation | assessment of operating conditions by means of a standardized score: surgical rating score (Martini et al. Evaluation of surgical conditions during laparoscopic surgery in patients with moderate vs. deep neuromuscular block. Br J Anaesth 2014; 112: 498-505: 1. extremely poor conditions 2. poor conditions 3. acceptable conditions 4. good conditions 5. optimal conditions The surgical rating score is assessed every 15 min together with abdominal wall length and depth of neuromuscular block |
| changes of abdominal distension or surgical Rating score (SRS) induced by additional analgesics, sedatives or neuromuscular blocking agents | during operation | If a bolus of an analgesic, sedative or neuromuscular blocking agent is required because of inadequate anesthesia during the operation, all measurements mentioned above are performed immediately after the injection of the drug in order to assess the effect of the bolus injection. |
Countries
Germany
Outcome results
None listed