Residual Neuromuscular Blockade in Pediatric Anesthesia

Overview

Residual neuromuscular blockade (RNB) is frequent and it is associated with postoperative morbidity and mortality. The incidence of the RNB in pediatric anesthesia is currently not known. The aim of this prospective observational cohort study is to evaluate the early RNB just before extubation and late RNB at the time of arrival to postanesthetic care unit (PACU).

Full Title of Study: “Residual Neuromuscular Blockade in Paediatric Patients Before Extubation and in Postanesthetic Care Unit:Prospective Observational Cohort Study”

Study Type

  • Study Type: Observational
  • Study Design
    • Time Perspective: Prospective
  • Study Primary Completion Date: December 2017

Detailed Description

Residual neuromuscular blockade (RNB) is frequent and it is associated with negative impact on postoperative morbidity and mortality. The incidence of the RNB in adult is well described, however in pediatric subpopulation it is currently not known. The aim of this prospective observational cohort study is to evaluate the early RNB just before extubation and late RNB at the time of arrival to postanesthetic care unit (PACU). In the trial will be enrolled all pediatric patients (28 weeks of age and older – 19 years old) whom will be administered neuromuscular blocking agent during anesthesia. The demographic data will be collected including: age, weight, type of surgery, ASA status. The anesthesia management will be described including: airway management, type and cumulative dose of neuromuscular blocking agent (NMBA) and time and dose of the last administered bolus of NMBA. The residual neuromuscular blockade will be measured according to the standards: TOF Watch accelerometry at the moment prior to extubation (two measurements) in TOF mode and at the arrival to postanesthetic care unit (PACU) (two measurements) in TOF mode.

Interventions

  • Device: Residual neuromuscular blockade measurement
    • Just prior extubation in OR and at the arrival to PACU the residual neuromuscular blockade will be measured by accelerometry

Arms, Groups and Cohorts

  • Paediatric patients after NMBA administration
    • Paediatric patients undergoing surgery with neuromuscular blockade

Clinical Trial Outcome Measures

Primary Measures

  • Early residual neuromuscular blockade
    • Time Frame: before extubation
    • Just prior extubation the residual neuromuscular blockade will be measured by accelerometry

Secondary Measures

  • Late neuromuscular blockade
    • Time Frame: at arrival to PACU
    • At the arrival to PACU the residual neuromuscular blockade will be measured by accelerometry

Participating in This Clinical Trial

Inclusion Criteria

  • Paediatric patients undergoing surgery with neuromuscular blocking agents were administered with the age limits

Exclusion Criteria

  • weight under 3000 grams
  • neuromuscular disease
  • haemodynamic impairment (vasopressor need)
  • planned postoperative mechanical ventilation

Gender Eligibility: All

Minimum Age: 29 Weeks

Maximum Age: 19 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Brno University Hospital
  • Provider of Information About this Clinical Study
    • Principal Investigator: Petr Štourač, MD, doc.MD.Ph.D – Brno University Hospital

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