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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
66
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
Beijing Tiantan Hospital
Beijing, China
The amplitude of MEP
mean value of amplitudes of TceMEPs in abductor pollicis brevis muscles of both upper extremities
Time frame: 5 minutes after dura opening
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.
Time frame: 10, 20, 30 and 60 minutes after dura opening
The latencies of MEPs
Mean value of latencies of TceMEPs in abductor pollicis brevis muscles of both upper extremities
Time frame: 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.
Time frame: during the surgery
Adverse effects of sugammadex
Anaphylaxis, arrhythmias, post-procedure pain, nausea and vomiting, fever and diarrhea, etc.
Time frame: 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).
Time frame: during the surgery
Recurrence of neuromuscular blockade
Recurrence of neuromuscular blockade at the end of surgery.
Time frame: At the end of surgery
Motor function assessment
SMP-a scale
Time frame: 5 days after surgery
Total bleeding volume
Total bleeding volume during the surgery
Time frame: during the surgery
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.