This study aimed for Determination of the impacts of deep neuromuscular blockade (DNMB) on surgical outcomes, consumption of perioperative opioid analgesia, and serum levels of inflammatory cytokines in comparison to moderate NMB (MNMB).
The primary efficacy point is the extent of change in serum levels of the estimated inflammatory cytokines in PO samples relative to the preoperative levels. The secondary endpoints include the total dose of IO fentanyl and PO morphine, PO pain scores, and surgeons' rating of the surgical conditions.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
88
A TOF-Watch® SX-acceleromyograph will be applied to the adductor pollicis muscle and calibrated to monitor response and degree of NMB. Anesthesia will be induced with IV propofol (1.5-2.5 mg/kg) and rocuronium bromide 0.6 mg/Kg, and the trachea will be intubated at train-of-four (TOF) 0. Anesthesia will be maintained with 50% air in oxygen and an end-tidal concentration of 2-3% sevoflurane. In the DNMB group, rocuronium infusion was used to provide 0.48-0.72 mg/kg/h to maintain PTC 0-1.
For patients in the MNMB group, rocuronium will be given as 0.2 mg/kg to maintain a post-tetanic count (PTC) of \>1, and TOF in the range of 0-2.
Faculty of Medicine Menoufia University
Menoufia, Eg.mn, Egypt
RECRUITINGchange in serum levels of the estimated inflammatory cytokines
The frozen serum samples will be used to estimate serum biomarkers via a quantitative sandwich enzyme-linked immunosorbent assay (ELISA) technique, and the results will be read using a 96-well microplate ELISA reader (Dynatech MR 7000). The studied biomarkers include serum tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, and IL-6.
Time frame: before induction of anesthesia and from the controls. Three PO samples (S2-4) will be obtained immediately at PACU admission, and 24 and 72 hours after surgery.
total dose of IO fentanyl
total dose of IO fentanyl in mg
Time frame: Intraoperative period and first 24 hours postoperative
PO morphine
Post operative morphine consumption in mg
Time frame: First 24 hours postoperative
Pain scores
Postoperative pain measured by visual analogue scale
Time frame: Immediately after recovery,2 hours,4,hours ,6 hours ,12 hours,24 hours postoperative
Surgeons satisfaction
the surgical condition will be described as excellent, good, acceptable, or poor, and will be rated on a 4-point scale
Time frame: At the end of surgery
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