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| ID | Type | Description | Link |
|---|---|---|---|
| U1111-1190-7993 | Other Identifier | WHO-UTN |
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The antagonism of neuromuscular blocking agents (NMBA) (or curares), as well as the antagonism of other drugs used in anesthesia, is a major challenge for the speciality.
Residual paralysis is indeed a risk factor for post-operative morbidity and mortality and antagonization of curares at the end of the procedure is associated with a reduction in mortality .
Its use should be as large as possible and its contraindications are extremely rare.
The antagonism of the NMBA reduces the duration of the neuromuscular block and the complications that are associated .
In this study, the investigators use mivacurium (or Mivacron) as non-depolarizing curare and neostigmine as an antagonist.
Neostigmine reduces the duration of the neuromuscular block induced by mivacurium, By reducing the breakdown of acetylcholine, neostigmine induces an increase in acetylcholine in the synaptic cleft which competes for the same binding site as nondepolarizing neuromuscular blocking agents, and reverses the neuromuscular blockade.
But the use of neostigmine in current practice is not very widespread in this clinical situation.
The reduction in the duration of the block is significant in comparison with a spontaneous recovery .
Moreover, spontaneous recovery is not always complete and sometimes very long.
Nevertheless, its action is effective and this study could support this use but also specify the duration and the quality of the return to normal of the neuromuscular transmission.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| GROUP 1 | Active Comparator | A group receiving neostigmine (40 mcg / kg) when the block Neuromuscular block's recovery measured by acceleromyography is 1 response of 4 in TOF mode (Train Of Four) |
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| GROUP 2 | Active Comparator | A group receiving neostigmine (40 mcg / kg) when the block Neuromuscular block's recovery measured by acceleromyography is 2 response of 4 in TOF mode (Train Of Four) |
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| GROUP 3 | Active Comparator | A group receiving neostigmine (40 mcg / kg) when the block Neuromuscular block's recovery measured by acceleromyography is 3 response of 4 in TOF mode (Train Of Four) |
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| GROUP 4 | Active Comparator | A group receiving neostigmine (40 mcg / kg) when the block Neuromuscular block's recovery measured by acceleromyography is 4 response of 4 in TOF mode (Train Of Four) |
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| CONTROL | Active Comparator |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Neostigmine (40 mcg / kg) at different time of neuromuscular block's recovery | Drug |
| ||
| Measure | Description | Time Frame |
|---|---|---|
| Change in TOF ( Train Of Four) measure | for each patient, measure of Train Of Four at 3, 6, 9, 12, 15 minutes |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Michel Baurain | Bruxelles Capitale | 1070 | Belgium |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 7880668 | Result | Baurain MJ, Dernovoi BS, d'Hollander AA, Hennart DA. Comparison of neostigmine-induced recovery with spontaneous recovery from mivacurium-induced neuromuscular block. Br J Anaesth. 1994 Dec;73(6):791-4. doi: 10.1093/bja/73.6.791. | |
| 16183681 | Result | Baillard C, Clec'h C, Catineau J, Salhi F, Gehan G, Cupa M, Samama CM. Postoperative residual neuromuscular block: a survey of management. Br J Anaesth. 2005 Nov;95(5):622-6. doi: 10.1093/bja/aei240. Epub 2005 Sep 23. |
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| ID | Type | URL | Comment |
|---|---|---|---|
| Study Protocol | View IPD |
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| ID | Term |
|---|---|
| D009388 | Neostigmine |
| ID | Term |
|---|---|
| D050338 | Phenylammonium Compounds |
| D000644 | Quaternary Ammonium Compounds |
| D000588 | Amines |
| D009930 | Organic Chemicals |
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A control group : not receiving an antagonist (spontaneous recovery)
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| Spontaneous recovery |
| Other |
just measuring the Train Of Four at 3 6 9 12 and 15 minutes and measure the Train Of Four Ratio |
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| 10719950 | Result | Szenohradszky J, Fogarty D, Kirkegaard-Nielsen H, Brown R, Sharma ML, Fisher DM. Effect of edrophonium and neostigmine on the pharmacokinetics and neuromuscular effects of mivacurium. Anesthesiology. 2000 Mar;92(3):708-14. doi: 10.1097/00000542-200003000-00015. |
| D009861 |
| Onium Compounds |