Anesthesia, General, Neuromuscular Transmission Disorders
Conditions
Brief summary
Many drugs have an influence on neuromuscular transmission. In clinical practice, neuromuscular blocking agents are commonly used, but even in the absence of neuromuscular blocking agents, anesthetic drugs can influence neuromuscular transmission. Especially volatile anesthetic agents have a clinical impact on neuromuscular transmission, they have been shown to prolong and deepen the effect of neuromuscular blocking agents. But even in the absence of neuromuscular blocking agents, volatile anesthetics can impair neuromuscular transmission. One mechanism of action is the desensitization of the acetylcholine receptors by shifting them from a normal to a desensitized state. This effect can weaken neuromuscular transmission by reducing the margin of safety that normally exists at the neuromuscular junction, or can cause an apparent increase in the capacity of neuromuscular blocking agents to block transmission. In this study, the influence of sevoflurane and propofol on the maximum force, maximum speed of contraction and relaxation will be measured at the adductor pollicis in patients having general anesthesia without the use of neuromuscular blocking agents. Maximum force and speed of contraction and relaxation will be measured before and after anesthesia by either sevoflurane or propofol. Primary outcome is the influence of either anesthetic agent on maximum muscular force and speed of contraction - relaxation, and if this influence is greater for volatile anesthetic agents than for intravenous anesthetic agents.
Interventions
DRUGSevoflurane
Anesthesia will be maintained by sevoflurane.
DRUGPropofol
Anesthesia will be maintained by propofol.
Sponsors
Brugmann University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Patients (male or female) from 18 - 80 years * Scheduled for surgery without the use of neuromuscular blocking agents * Health care insurance in Belgium * Written informed consent
Exclusion criteria
* Any pathology involving neuromuscular transmission * Confirmed neuropathy of any origin * Expected anesthesia duration \< 30 min * Renal insufficiency defined as a glomerular filtration rate \< 40 mL/min/m2 * Hepatic insufficiency defined as an increase \> 1.5 \* normal value of hepatic enzymes * Confirmed or suspected pregnancy * Language barrier * Any patient which will receive unplanned neuromuscular blocking agents during surgery * Any history of personal or familial suspected malignant hyperthermia
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Maximum force at the adductor pollicis | 3 hours | Maximum force developed by a voluntary contraction of the adductor pollicis will be measured during isometric contraction. Maximum force developped before and after anesthesia will be compared. The difference in force (Newton) will be measured. |
| Maximum speed of contraction at the adductor pollicis | 3 hours | Maximum speed of contraction developed by a voluntary contraction of the adductor pollicis will be measured during isometric contraction. Maximum speed of contraction developped before and after anesthesia will be compared. The difference in force (Newton/seconds) will be measured. |
| Maximum speed of relaxation at the adductor pollicis | 3 hours | Maximum speed of relaxation developed by a voluntary contraction of the adductor pollicis will be measured during isometric contraction. Maximum speed of relaxation developped before and after anesthesia will be compared. The difference in force (Newton/seconds) will be measured. |
Countries
Belgium
Outcome results
None listed