Rocuronium vs Cis-atracurium: Do Rocuronium Still 'ROCKS' In Coronary Artery Bypass Grafting

Institut Jantung Negara

Status: Completed

Conditions: Coronary Artery Disease; Postoperative Pulmonary Atelectasis; Postoperative Pulmonary Complication; Hypothermic Cardiopulmonary Bypass; Coronary Artery Bypass Grafting; Neuromuscular Blockade

Treatments: Drug: Nimbex 10 MG in 5 ML Injection; Drug: Rocuronium Bromide 10 MG/ML

Study type: Observational

Funder types: Other

Identifiers

NCT06102915

IJNREC/631/2023

Details and patient eligibility

About

The current trend in most cardiac surgeries was to use rocuronium as it provides faster recovery in train-of-four ratio compared to other aminosteroid non-depolarising neuromuscular blocker. However, as most cardiac centres' standard of care does not perform any neuromuscular monitoring nor antagonism of neuromuscular blockade effect, residual neuromuscular blockade could potentially be the key to delayed extubation. As such, Cis-atracurium's organ-independent Hofmann elimination could be in favour.

Enrollment: 289 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• All patients that undergo general anaesthesia for CABG surgery requiring neuromuscular blockade of either rocuronium or cis-atracurium

Exclusion criteria

1. Recent history of pulmonary infection four weeks before surgery
2. Exposed to both neuromuscular blockade within 24 hours perioperatively
3. Patients intubated or on tracheostomies pre-operatively
4. Any missing or incomplete data

Trial design

289 participants in 2 patient groups

Rocuronium

Description:

Rocuronium 1mg/kg to be given at induction of anaesthesia and another 1mg/kg would be given when the patient is on hypothermic cardiopulmonary bypass

Treatment:

Drug: Rocuronium Bromide 10 MG/ML

Cis-atracurium

Description:

Cis-atracurium 0.2mg/kg to be given at induction of anaesthesia and another 0.2mg/kg would be given when the patient is on hypothermic cardiopulmonary bypass

Treatment:

Drug: Nimbex 10 MG in 5 ML Injection