The purpose of this study is to determine whether deep neuromuscular blockade provides better surgical conditions than moderate neuromuscular blockade in patients undergoing vocal cord resections requiring jet ventilation.
To optimize anatomical exposure and to minimize direct manipulation of local lesions endotracheal intubation often is avoided in patients undergoing vocal cord surgery. Instead intermittent so called jet ventilation is carried out by using the Hunsaker Mon-jet tube. The safe conduct of these procedures requires full muscle paralysis. In clinical practice, however, deep neuromuscular blockade (NMB) usually cannot be established for this relatively short surgery (\<1h) because of an increased risk of prolonged NMB and postoperative ventilation. The novel neuromuscular blockade reversal agent sugammadex may prove particularly useful in this patient population because it allows fast and reliable reversal of even deep NMB. Deeper muscle paralysis during vocal cord surgery may be associated with better surgical conditions. The purpose of this study is to determine whether deep neuromuscular blockade provides better surgical conditions than moderate neuromuscular blockade in patients undergoing vocal cord resections requiring jet ventilation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
TRIPLE
Enrollment
12
Moderate neuromuscular blockade with rocuronium bromide
Deep neuromuscular blockade with rocuronium bromide
Reversal with sugammadex sodium
MUHC
Montreal, Quebec, Canada
Five-point surgical rating scale (SRS)
Surgical conditions during surgery will be assessed by the surgeon using a five-point surgical rating scale at 10 minutes intervals
Time frame: during surgery, an average period of 50 minutes
Drug dosages
Drugs and dosages used during the study
Time frame: Through study completion, an average of 4 hours
Time to extubation
Time from reversal to optimal extubation conditions (TOF ratio \<0.9)
Time frame: During the stay in the operation room, an average of 60 minutes
Heart rate
Time frame: During the stay in the operation and recovery room, an average of 4 hours
Arterial blood pressure
Time frame: During the stay in the operation and recovery room, an average of 4 hours
Oxygen saturation
Time frame: During the stay in the operation and recovery room, an average of 4 hours
Respiratory rate
Time frame: During the stay in the operation and recovery room, an average of 4 hours
Body temperature
Time frame: During the stay in the operation and recovery room, an average of 4 hours
Duration of surgery
Time frame: During the stay in the operation room, an average of 50 minutes
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Reversal with sugammadex sodium
Duration of post-anesthesia care unit (PACU) stay
Time spent in the PACU
Time frame: During the stay in the recovery room, an average of 3 hours
Pain score
On an 11-point numerical rating scale from 0 = no pain, to 10 = most severe pain imaginable at PACU
Time frame: During the stay in the operation and recovery room, an average of 4 hours
Occurence of nausea/vomiting
Time frame: During the stay in the operation and recovery room, an average of 4 hours
Sedation
On a five-point scale ranging from 0 = normal alertness to 5 = not aroused by a painful stimulus at PACU
Time frame: During the stay in the operation and recovery room, an average of 4 hours