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The effect of deep neuromuscular blockade (NMB) during spine surgery reduced postoperative pain and bleeding in recent studies. Therefore by reducing these two factors, which were the contributing factors for postoperative delirium, deep NMB is expected to reduce the postoperative delirium. This study was designed to determine whether the deep NMB lowered the incidence of delirium after lumbar surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Deep NMB | Experimental | A TOF count of 0, and a PTC of 1 to 3 will be maintained, as close to 2 twitches as possible |
|
| Moderate NMB | Active Comparator | A TOF count of 1 to 3 will be maintained, as close to 2 twitches as possible |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Rocuronium for deep NMB | Drug | Deep neuromuscular blockade will be maintained using continuous infusion of rocuronium. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Delirium by CAM-ICU | Occurrence of delirium assessed by CAM-ICU during the post-operative 5 days | from just after surgery at the PACU to post-operative 5 days |
| Measure | Description | Time Frame |
|---|---|---|
| Intramuscular pressure | Intramuscular pressure at the para-spinal muscles | intraoperative |
| Peak inspiratory airway pressure | Peak inspiratory airway pressure (mmHg) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Seok Kyeong Oh, MD, PhD | Korea University Guro Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Seok Kyeong Oh | Seoul | Gangnam-gu | 06294 | South Korea |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30060380 | Result | Morino T, Hino M, Yamaoka S, Misaki H, Ogata T, Imai H, Miura H. Risk Factors for Delirium after Spine Surgery: An Age-Matched Analysis. Asian Spine J. 2018 Aug;12(4):703-709. doi: 10.31616/asj.2018.12.4.703. Epub 2018 Jul 27. | |
| 31013693 | Result | Oh SK, Kwon WK, Park S, Ji SG, Kim JH, Park YK, Lee SY, Lim BG. Comparison of Operating Conditions, Postoperative Pain and Recovery, and Overall Satisfaction of Surgeons with Deep vs. No Neuromuscular Blockade for Spinal Surgery under General Anesthesia: A Prospective Randomized Controlled Trial. J Clin Med. 2019 Apr 12;8(4):498. doi: 10.3390/jcm8040498. |
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| ID | Term |
|---|---|
| D013122 | Spinal Diseases |
| ID | Term |
|---|---|
| D001847 | Bone Diseases |
| D009140 | Musculoskeletal Diseases |
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| ID | Term |
|---|---|
| D000077123 | Rocuronium |
| ID | Term |
|---|---|
| D000732 | Androstanols |
| D000731 | Androstanes |
| D013256 | Steroids |
| D000072473 | Fused-Ring Compounds |
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| Rocuronium for moderate NMB | Drug | Moderate neuromuscular blockade will be maintained using continuous infusion of rocuronium. |
|
|
| intraoperative |
| 31860601 | Result | Kang WS, Oh CS, Rhee KY, Kang MH, Kim TH, Lee SH, Kim SH. Deep neuromuscular blockade during spinal surgery reduces intra-operative blood loss: A randomised clinical trial. Eur J Anaesthesiol. 2020 Mar;37(3):187-195. doi: 10.1097/EJA.0000000000001135. |
| 12486343 | Result | Taylor H, McGregor AH, Medhi-Zadeh S, Richards S, Kahn N, Zadeh JA, Hughes SP. The impact of self-retaining retractors on the paraspinal muscles during posterior spinal surgery. Spine (Phila Pa 1976). 2002 Dec 15;27(24):2758-62. doi: 10.1097/00007632-200212150-00004. |
| D011083 |
| Polycyclic Compounds |