General Anesthesia, Postoperative Complications
Conditions
Keywords
robotic surgery, laparoscopic surgery, neuromuscular blockade, postoperative complication
Brief summary
During robotic laparoscopic surgery, a high intraperitoneal pressure may result in high airway pressure and inadequate perfusion of the abdominal organs, and as a result the postoperative outcomes. Degree of neuromuscular blockade (NMB) can affect the intraperitoneal pressure. In this study, the patients undergoing robotic laparoscopic surgery will be assigned to deep NMB group and moderate NMB group. Perioperative outcomes including maximal intraperitoneal pressure, maximal intraoptic pressure, quality of emergence, postoperative pain, and incidence of postoperative respiratory complication will be compared. The results of this study will provide evidence for optimizing NMB protocol of robotic laparoscopic surgery.
Interventions
DRUGRocuronium
rocuronium is a neuromuscular blocking agent with a duration of 40 minutes
OTHERcontinuous infusion
rocuronium is continuously infused
OTHERintermittent injection
rocuronium is intermittently given
Sponsors
Air Force Military Medical University, China
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
TRIPLE (Subject, Caregiver, Outcomes Assessor)
Masking description
Muscle relaxant will be given by a specific investigator that is not involved in anesthesia and outcome assessment
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* patients scheduled for elective robotic laparoscopic surgery under general anesthesia * American Society of Anesthesiologists status 1-2 * Body mass index of 18-30kg/m2 * Patients scheduled to be positioned in trendelenburg position during surgery
Exclusion criteria
* Patients allergic to rocuronium * Patients with neuromuscular dysfunction * Patients with existed pulmonary diseases * Patients with hepatic or renal dysfunction
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| incidence of postoperative major respiratory complications | from end of surgery to discharge, at an average of 4 days | incidence of pneumonia and atelectasis |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| maximal airway pressure | from establishment of pneumoperitoneum to end of pneumoperitoneum, at an average of 3 hours | airway pressure is titrated to as low as possible as long as the end tidal carbon dioxide partial pressure is lower than 40 mmHg |
| minimal cerebral oxygen saturation | from start of surgery to end of surgery, at an average of 3.5 hours | cerebral oxygen saturation is continuously monitored during surgery |
| maximal intraocular pressure | from start of surgery to end of surgery, at an average of 3.5 hours | intraocular pressure is monitored every 10 minutes during surgery |
| number of surgeon asking for improving muscle relax | from start of surgery to end of surgery, at an average of 3.5 hours | when the surgeon is unsatisfied with the muscle relax, he can tell the anesthetist |
| time to extubation | from end of sevoflurane inhalation to extubation, at an average of 20 minutes | criteria of extubation: spontaneous respiratory rate\>10 per minute and end tidal carbon dioxide partial pressure\<45mmHg |
| incidence of nausea and vomiting in post-anesthesia care unit | from admittance to post-anesthesia care unit(PACU) to discharge from PACU, at an average of 30 minutes | — |
| incidence of residual neuromuscular blockade in the post-anesthesia care unit | from admittance to post-anesthesia care unit(PACU) to discharge from PACU, at an average of 30 minutes | residual neuromuscular blockade is defined as time of head-lift or limb-lift\<10 seconds |
| visual analogue scale at 24 hours after surgery | end of surgery to 24 hours after surgery | the patients are asked to mark the score they feel, 0 is no pain,100 is untolerated pain |
| expense after surgery | end of the surgery to discharge,at an average of 4 days | the expense from immediately after surgery to discharge |
| satisfaction score of the patients | from end of surgery to discharge,at an average of 4 days | the patient is asked to give a score between 0 and 10, 0 means not satisfied,10 means totally satisfied. |
| incidence of shoulder pain in 24 hours after surgery | from end of surgery to 24 hours after surgery | — |
Contacts
Primary ContactZhihong Lu
Backup ContactHailong Dong
Outcome results
None listed