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Transcranial motor evoked potential (TcMEP) monitoring is conventionally performed during neurosurgical procedures without or with minimal neuromuscular blockade (NMB) because of its potential interference with signal interpretation. However, full blockade offers increased anesthetic management options and facilitates surgery. Here, investigators want to assess the effect of Sugammadex during TcMEP in adult patients. Sugammadex is designed to encapsulate rocuronium and reverse rocuronium-induced neuromuscular blockade. 64 patients undergoing thoracic or lumbar spinal surgery will be randomly allocated into sugammadex group or control group under a ratio of 1 to 1. Patients will receive either continuous infusion of rocuronium to produce blockade maintained at least two twitches in Train-of-Four (TOF), rocuronium infusion will be discontinued and 2 mg/kg of sugammadex will be infused while dura opening in sugammadex group. Whereas no muscle relaxant will be given after anesthetic induction in control group. The primary aim of this study is to compare mean value of amplitudes of TcMEPs in abductor pollicis brevis muscles of both upper extremities 5 minutes after dura opening.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Sugammadex group | Active Comparator |
| |
| control group | No Intervention |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Sugammadex | Drug | Sugammadex group received a rocuronium infusion producing blockade by qualitative train-of-four ≥2 at the ulnar nerve. 2 mg/kg of Sugammadex will be infused when conducting TcMEP |
| Measure | Description | Time Frame |
|---|---|---|
| The amplitude of MEP | mean value of amplitudes of TceMEPs in abductor pollicis brevis muscles of both upper extremities | 5 minutes after dura opening |
| Measure | Description | Time Frame |
|---|---|---|
| The amplitude of MEP | Mean value of amplitudes of TceMEPs in abductor pollicis brevis muscles of both upper extremities 10, 20, 30 and 60 minutes after dura opening. | 10, 20, 30 and 60 minutes after dura opening |
| The latencies of MEPs |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Ruquan Han, M.D., Ph.D | Department of Anesthesiology, Beijing Tiantan Hospital | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Beijing Tiantan Hospital | Beijing | 100070 | China |
The study protocol, statistical analysis plan and informed consent form will be shared beginning 3 months and ending 5 years following 5 years article publication.
Beginning 3 months and ending 5 years following 5 years article publication
Proposals should be directed to ruquan.han@ccmu.edu.cn. To gain access, data requestors will need to sign a data access agreement.
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| ID | Term |
|---|---|
| D000077122 | Sugammadex |
| ID | Term |
|---|---|
| D047408 | gamma-Cyclodextrins |
| D003505 | Cyclodextrins |
| D047028 | Macrocyclic Compounds |
| D011083 | Polycyclic Compounds |
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|
Mean value of latencies of TceMEPs in abductor pollicis brevis muscles of both upper extremities
| 5, 10, 20, 30 and 60 minutes after dura opening. |
| Respiratory parameters | Peak respiratory pressures and incidence of peak insufflation pressure of more than 25cmH2O. | during the surgery |
| Adverse effects of sugammadex | Anaphylaxis, arrhythmias, post-procedure pain, nausea and vomiting, fever and diarrhea, etc. | during and 24 hours after the surgery |
| Incidence of body movement | either nociception-induced movement (defined as "coughing" or reflexive limb movement temporally related to MEP stimulation) or excessive field movement (defined as grossly visible movement as determined by surgical and anesthesia teams). | during the surgery |
| Recurrence of neuromuscular blockade | Recurrence of neuromuscular blockade at the end of surgery. | At the end of surgery |
| Motor function assessment | SMP-a scale | 5 days after surgery |
| Total bleeding volume | Total bleeding volume during the surgery | during the surgery |
| D003912 |
| Dextrins |
| D013213 | Starch |
| D005936 | Glucans |
| D011134 | Polysaccharides |
| D002241 | Carbohydrates |