Ignite Creation Date:
2024-05-06 @ 6:30 PM
Last Modification Date:
2024-10-26 @ 2:49 PM
Study NCT ID:
NCT05689957
Status:
COMPLETED
Last Update Posted:
2023-01-19
First Post:
2020-12-30
Brief Title:
Moderate vs Deep Neuromuscular Block in Lower Pressure Pneumoperitoneum
Sponsor:
Universiti Sains Malaysia
Organization:
Universiti Sains Malaysia
Study Overview
Official Title:
Evaluation of Surgical Condition During Laparoscopic Gynaecological Surgery in Patient With Moderate vs Deep Neuromuscular Block in Lower Pressure Pneumoperitoneum
Status:
COMPLETED
Status Verified Date:
2023-01
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
The investigators hypothesized that deep neuromuscular block compare to moderate neuromuscular block would reduce the rate of increasing intraabdominal pressure and operation can be completely done in lower pressure pneumoperitoneum and would improve laparoscopic space by measuring distance from the sacral promontory to the inserted trocar in patients undergoing laparoscopic gynaecological surgery
Detailed Description:
Laparoscopic surgery has increasing popularity and slowly replacing conventional open surgery as it offers more benefit to patient and health care practitioner The overall risk of complications during laparoscopic surgery is recognized to be lower than during laparotomy Laparoscopic hysterectomy compare to open vaginal hysterectomy reduces postoperative pain reduce post op analgesics requirement and shorter duration of hospital admission1 However the increase intra-abdominal pressure created during laparoscopic surgery can affect cardiovascular pulmonary and renal physiology Besides the risk of post-operative nausea and vomiting it is also stated that the pneumoperitoneum created during laparoscopic surgery is an important factor in the cause of postoperative shoulder pain2 Traditionally pneumoperitoneum created at 15mmHg3 Insufflation of intraabdominal carbon dioxide may cause post-operative shoulder pain up to 70 in some study in gynaecologic laparoscopic surgery 4 Use a lower pressure pneumoperitoneum might decrease postoperative pain decrease post-operative shoulder tip pain5 and reduce the risk of laparoscopic related complication6 Many studies used lower insufflation of intraabdominal pressure as an intraoperative intervention to reduce the complication78 However a lower intraabdominal pressure may worsen surgical space and increase the risk of conversion to open surgery
Though many factors contribute to the quality of surgical space include non-modifiable such as obesity previous abdominal surgery and modifiable factors such as anaesthesia related factor patient position and intraabdominal pressure Numerous studies also have been carried out showing that deep neuromuscular block improves surgical condition in different type of laparoscopic surgery includes robotic assisted laparoscopic surgery91011 Currently with the advancement of technology where neuromuscular monitoring is widely available and the selective reversal binding agent suggamadex where post-operative complication of inadequate reversal can be markedly reduced several studies have been done to observe the benefit of low intraabdominal pressure with deep neuromuscular block to surgical space quality and intraoperative complication related to high pressure intraabdominal complication compare to usual moderate block91012 However there is still few study objectively measure the possible effect of deep neuromuscular blocker on the surgical space and the ability of surgery to be completely done in low pressure pneumoperitoneum in laparoscopic gynaecological surgery
This study will compare the rate of increasing intraabdominal pressure skin to sacral promontary distance and post operative pain between deep neuromuscular block and moderate neuromuscular block
Though many factors contribute to the quality of surgical space include non-modifiable such as obesity previous abdominal surgery and modifiable factors such as anaesthesia related factor patient position and intraabdominal pressure Numerous studies also have been carried out showing that deep neuromuscular block improves surgical condition in different type of laparoscopic surgery includes robotic assisted laparoscopic surgery91011 Currently with the advancement of technology where neuromuscular monitoring is widely available and the selective reversal binding agent suggamadex where post-operative complication of inadequate reversal can be markedly reduced several studies have been done to observe the benefit of low intraabdominal pressure with deep neuromuscular block to surgical space quality and intraoperative complication related to high pressure intraabdominal complication compare to usual moderate block91012 However there is still few study objectively measure the possible effect of deep neuromuscular blocker on the surgical space and the ability of surgery to be completely done in low pressure pneumoperitoneum in laparoscopic gynaecological surgery
This study will compare the rate of increasing intraabdominal pressure skin to sacral promontary distance and post operative pain between deep neuromuscular block and moderate neuromuscular block
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
False
Is an FDA AA801 Violation?:
None