CompletedNot Applicable

Effects of Low-pressure Pneumoperitoneum Associated With Deep Pipecuronium-induced Neuromuscular Blockade on Hemodynamic Parameters for High Cardiovascular Risk Patient Undergoing General Anesthesia

Hungary10 participantsStarted 2023-01-08

Plain-language summary

Deep neuromuscular block (DNMB) during laparoscopy induces less haemodynamic stress by facilitating low-pressure pneumoperitoneum. the investigators tested the feasibility of pipecuronium-induced deep (post-tetanic count ≥1, train-of-four count = 0) NMB to allow low intraabdominal pressures and maintain cardiovascular stability in patients with low cardiac ejection fraction.MethodsTen adult, NYHA 3-4 surgical patients requiring non-elective abdominal surgery, were included. Pipecuronium bromide (PIPE) 0.09 mg/kg was used for muscle relaxation and maintenance of DNMB. Top-up doses of PIPE were administered when the post-tetanic count was 4-8. Intraabdominal pressures (IAP) were kept below 10 mmHg. Mean arterial pressure (MAP) was measured intra-arterially. Outcome measures used: weight in kilograms, height in meters, need for circulatory suppert (yes/no), success of maintenance (yes/no). Surgical field view was rated on a 5-point scale (1= extremely poor, 5 = optimal)

Who can participate

Age range18 Years – 65 Years

SexALL

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AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.

Inclusion Criteria: * high cardiovascular risk, class III- IV, according to the New York Heart Association classification of heart failure * Age: between 18- 65 years old. * ASA (American Society of Anesthesia score) 1- 3 * BMI between 18.5- 25 * Laparoscopic surgical interventions * Endotracheal intubation * Patient in supine position on operating table with one arm abducted and accessible. Exclusion Criteria: * Patients with diseases affecting neuromuscular functions (myopathies, severe liver and kidney failure). * Patients on medications affecting the neuromuscular function (magnesium,aminoglycosides). * Difficult airway or anticipated difficult airway. * pregnancy (a pregnancy test was performed for every female patient in childbearing age to rule out pregnancy); * Breastfeeding * Acute surgical indications * Chronic Obstructive Pulmonary Disease (COPD) * Glaucoma

What they're measuring

Succes of maintenance low-pressure pneumoperitoneum (6-10 mmHg) during laparascopic surgery

Timeframe: During laporoscopic surgery

Trial details

NCT IDNCT06517524

SponsorTamas Vegh, MD

Sponsor typeOTHER

Study typeOBSERVATIONAL

Primary completion2024-06-05