Deep Neuromuscular Block With Low Pressure Pneumoperitoneum in Laparoscopic Abdominal Surgeries

Tanta University

Status: Completed

Conditions: Low Pressure; Pneumoperitoneum; Laparoscopic Abdominal Surgeries; Deep Neuromuscular Block

Treatments: Other: Deep neuromuscular block; Other: Moderate neuromuscular block

Study type: Interventional

Funder types: Other

Identifiers

NCT06242262

36264PR461/12/2023

Details and patient eligibility

About

The aim of this study is to evaluate the effect of deep neuromuscular block on postoperative pain, duration of surgery, quality of surgical field, length of recovery room stays, Total amount of rescue analgesic, postoperative nausea/vomiting, and length of hospital stay.

Full description

Acute-pain management in surgery patients is accompanied by an array of negative consequences, including increased morbidity, impaired physical function, and quality of life, slowed recovery, prolonged opioid use during and after hospitalization, and increased cost of care.

Reducing pneumo-peritoneum (PP) is one technique for reducing postoperative pain. The effect of low PP on postoperative pain remains a controversial topic with other studies reporting no difference in postoperative pain levels between the Two pressures.

Deep neuromuscular block (DNMB) in abdominal surgeries is associated with various advantages, such as lower abdominal pressure, lower pain and rescue opioid consumption, as well as less bleeding. DNMB may facilitate the use of reduced insufflation pressure without compromising the surgical field of vision. However, its usage is limited due to a lack of predictable and rapid recovery with conventional NMB antagonists (neostigmine) or spontaneous recovery

Enrollment: 44 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age 18 to 65 years old.
• Both sexes.
• American Society of Anesthesiologists (ASA) physical status I-III.
• Patients scheduled for laparoscopic abdominal surgery.

Exclusion criteria

• Known allergies to cis-atracurium or neostigmine.
• Contraindications to the use of neostigmine, such as bronchial asthma, glaucoma, myocardial ischemia, and epilepsy.
• History of neuromuscular, renal, or hepatic disease; previous abdominal surgery.
• Treatment with drugs known to affect neuromuscular function.
• Preoperative hyperalgesia.
• Peripheral neuropathy is caused by diabetes.
• History of chronic analgesics treatment, drug, or alcohol abuse.
• Body mass index (BMI) > 35 kg/m2.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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44 participants in 2 patient groups

Deep neuromuscular block

Experimental group

Description:

Patients will receive deep neuromuscular block by using cis-atracurium

Treatment:

Other: Deep neuromuscular block

Moderate neuromuscular block

Other group

Description:

Patients will receive moderate neuromuscular block by using cis-atracurium.

Treatment:

Other: Moderate neuromuscular block