Neuromuscular Blockade
Conditions
Brief summary
To shorten induction time, some anesthesiologist gives a priming dose of muscle relaxant before starting Neuromuscular Transmission monitor (NMT). To properly evaluate neuromuscular function during the surgury, baseline supramaximal stimulation of the monitored nerve is mandatory. Not knowing if the priming dose of muscle relaxant affects the supramaximal stimulation current setting, The investigators designed this study to find out.
Detailed description
The NMT monitor module automatically determines the current needed for the supramaximal stimulus, and maintains this current throughout the procedure. The supramaximal current is the current above which there is no increase in the evoked muscle response. At this stimulus current, all motor units are firing in response to nerve stimulation. According to previous studies, the current was significantly increased in the presence of edema and peripheral neuropathy. In this study, the route of administration, dosage, dosage regimen, and treatment period are basically the same as the investigators anesthesia department's routine procedure for general anesthesia. The difference will be the time the investigators set between the priming dose to final dose of rocuronium is 2 minutes. The investigators use 2 minutes as the peak effect of rocuronium is 105±36S. To properly evaluate neuromuscular blockade during the surgery, baseline supramaximal stimulation of the monitored nerve is mandatory. Not knowing if the priming dose of muscle relaxant affects the supramaximal stimulation current setting, the investigators designed this study.
Interventions
PROCEDURERocuronium priming dose
Add the priming dose of rocuronium after the first supramaximal stimulation data measured
Sponsors
Taipei Medical University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
OTHER
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Patients receiving general anesthesia and use rocuronium for induction
Exclusion criteria
* Muscular disease * Peripheral neuropathy * Difficult airway or difficult mask ventilation * Allergy to study related medication * Pregnant woman * \< 20-year-old or \> 65-year-old * BMI \<18.5 or BMI\>24.9
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Supramaximal stimulation value | since general anesthesia induction to endotracheal tube intubation, about 10 minutes | whether the supramaximal stimulation changs after 2 minutes of priming dose of muscle relaxant use |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| supramaximal stimulation value change by time | since general anesthesia induction to endotracheal tube intubation, about 10 minutes | whether the supramaximal stimulation changs have a trend |
| dose of rocuronium | since general anesthesia induction to endotracheal tube intubation, about 10 minutes | whether the change of supramaximal stimulation change is muscle relaxant dose responsive |
| Time to intubation | since general anesthesia induction to endotracheal tube intubation, about 10 minutes | how long does it take from the full dose of muslce relaxant given to TOF count \<2 |
| Intubation condition | since general anesthesia induction to endotracheal tube intubation, about 10 minutes | the intubation condition with priming method used. Evaluate with scoring scale. scale range from 0-3. 0 presented as poor Jaw relaxation, closed vocal cord, and severe cough or bucking when intubation; to 3 represent a condition with good jaw relaxation, open vocal cord, and no repsponse to stimulation. |
Countries
Taiwan
Contacts
Primary ContactWei Chieh Lai, MD, MPH
Outcome results
None listed