Diaphragm Ultrasound to Predict Posteroperative Residual Blockade

Overview

This study is a prospective observational research approved by the Ethics Committee of the Peking Union medical college Hospital. Patients scheduled for elective non-abdominal and non-thoracic surgery among age of 19-65 years and American Society of Anesthesiologists Physical Status Classification(ASA) I or II were inrolled. Diaphragm ultrasonogram was measured pre and post operation. Diaphragm excursion and diaphragm thickening fraction during quiet breathing as well as deep breathing were assessed. Neuromuscular monitor was performed during operation, after proper calibration.

Study Type

  • Study Type: Observational
  • Study Design
    • Time Perspective: Prospective
  • Study Primary Completion Date: April 30, 2020

Interventions

  • Other: no intervention
    • no intervention

Clinical Trial Outcome Measures

Primary Measures

  • TOFr at extubation
    • Time Frame: within1 min before extubation
    • Neuromuscular function was monitored thoughout operation based neuromuscular monitoring guideline by an independent investigator. TOF ratio before extubation was recorded. The scale of TOFr range from 0 to 1. TOFr<0.9 indicate existance of residual neuromuscular blockade.
  • Diaphragm ultrasound parameter
    • Time Frame: within 1 min after extubation
    • Diaphragm excursion and thickening fraction was measured through ultrasonography within 2 min after extubation. Correlation between TOFr ratio and diaphragm parameters was explored.

Secondary Measures

  • reintubation rate
    • Time Frame: within 24 hour
    • If patients cannot breath by themselves after extubation, They need to be reintubated and mechanical ventilation need to be use to sustain their breathing.
  • Posteroperative pulmonary complication
    • Time Frame: 1 month
    • incidence of airway obstruction, bronchospasm, pulmonary aspiration of gastric contents, apnea, unexpected ICU admissions, atelectasis and pneumonia

Participating in This Clinical Trial

Enrollment criteria:

1. Patients who were scheduled for elective non-abdominal and non-thoracic surgery in Peking Union medical college hospital.

2. age of 19-65 years

3. American Society of Anesthesiologists Physical Status Classification(ASA) I or II.

4. Agree to informed consent

Exclusion criteria : Patients with neuromuscular diseases, diaphragmatic palsy, thoracic malformation, hand disabilities, chronic obstructive pulmonary disease, severe liver or kidney diseases, electrolyte or acid-base disorders, morbid obesity (body mass index ≥30 kg/m2), pregnancy, allergy to drugs used in the study, use of medication interfering neuromuscular transmission within 72hours and patients with predicted difficulty in maintenance of airway were excluded from this study. Written informed consent will be obtained before preoperative evaluation by an anesthesiologist.

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: 65 Years

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • Peking Union Medical College Hospital
  • Provider of Information About this Clinical Study
    • Principal Investigator: Jie YI, deputy director of surgery department – Peking Union Medical College Hospital

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