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WithdrawnNCT03369782Updated Mar 12, 2019

Effect of NMBA on Surgical Conditions in THR

A Phase 4 interventional study of Rocuronium and Sugammadex in Surgery and Postoperative Pain, sponsored by Algemeen Ziekenhuis Maria Middelares. Withdrawn at 1 site in Belgium. Open to participants aged 18 Years to 90 Years. Per ClinicalTrials.gov, last updated 2019-03-12.

Sponsored by Algemeen Ziekenhuis Maria Middelares · Phase 4, Interventional, and Treatment

Why this study was withdrawn
refocusing of research priorities
Phase
Phase 4
Study type
Interventional
Enrollment
0
Allocation
Randomized
Ages
18 Years to 90 Years
Sex
All
01

Study summary

During Total hip replacement arthroplasty (THA), the hip joint first must be luxated in order to have access to the joints. A lot of force and torque must be carried out on the joint to perform this manipulation. This is both difficult for the surgeon and may cause additional tissue damage and postoperative pain. After placement of the prosthesis and reduction of the joint, the tension of the hip joint must be evaluated by the surgeon to ascertain the adequacy of the prosthesis. During luxation, minimal muscle tension would be ideal, while after reduction of the joint, normal muscle tension is desired to permit assessment of the mechanics of the hip joint.

The aim of the study is to investigate whether deep neuromuscular block, combined with a reversal before mechanics assessment improves surgical conditions, surgical time, and postoperative patient comfort.

Read the detailed description

2X20 patients are randomised: Rocuronium-group (R-group) and Placebo-group (P-group).

All patients receive standardised multimodal intravenous analgesia. After standardised induction of anasthesia and patient positioning, the patient is administered either placebo or rocuronium 0.9 mg/kg, followed by continuous infusion of either placebo or rocuronium 0.4 mg/kg/h. 1 minute before reduction of the hip joint, the patient is administered either sugammadex (R-group) or placebo (P-group) for full reversal of the neuromuscular block.

During the surgery, time points are recorded for: incision, start luxation of the joint, start reduction of the joint, start skin closure.

The surgeon is blinded for patient allocation. At three moments (after luxation, just before reduction of the joint, and after assessment of joint mechanics), the surgeon is asked to appraise the surgical conditions on an analogue scale.

Postoperative analgesic consumption and pain scores are recorded. VAS scores for knee pain and hip pain are assessed before surgery, at the moment of discharge from the post-anesthesia care unit (=D0), the morning after surgery (=D1), at D2, and at D7.

02

Conditions studied

  • Surgery
  • Postoperative Pain

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Keywords

  • Muscle Tension
  • Skeletal Muscle Relaxants
  • Arthroplasties, Hip Replacement
  • Rocuronium
  • sugammadex
03

Who can participate

Ages eligible
18 Years to 90 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • signed informed consent
  • eligible for primary THA
  • BMI \<35

Exclusion criteria

Exclusion Criteria:

  • neurological or psychiatric disorders
  • intolerance or allergy against investigational drugs or any of the drugs used in the standardized analgetics scheme (acetaminophen, diclofenac, ketamine, clonidine, lidocaine)
04

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
0 participants (actual)

Study arms

  • Placebo comparator
    Placebo

    Placebo alternative for rocuronium and for sugammadex

    Drug: Placebo

  • Active comparator
    Rocuronium

    Rocuronium as bolus and in syringe pump Sugammadex just before reduction of the joint

    Drug: Rocuronium · Drug: Sugammadex

Interventions

  • DrugRocuronium

    rocuronium is administered in bolus and continuous infusion

    Also known as: Esmeron

  • DrugSugammadex

    Sugammadex is administered just before reduction of the joint

    Also known as: Bridion

  • DrugPlacebo

    Placebo is administered as alternative to rocuronium in a bolus and in a syringe pump. Placebo is administered as alternative to sugammadex

    Also known as: Saline 0.9%

05

What researchers measure

Primary outcomes

  1. Surgical conditions during luxation on a four-grade numeric scale

    Excellent - good but not optimal - poor but acceptable - unacceptable

    Time frame: during surgery, during luxation of the joint

Secondary outcomes

  1. Patient reported pain scores on a VAS score (0-100 ; 0=no pain , 100=worst pain)

    Patient reported pain scores in knee and hip after surgery at day 0-1-2-7

    Time frame: day 0-1-2-7 (day 0 = day of surgery)

  2. surgery time

    time (in minutes) of surgery between incision and reduction, and between reduction and skin closure

    Time frame: during surgery

  3. Surgical conditions during reduction of the joint on a four-grade numeric scale

    Excellent - good but not optimal - poor but acceptable - unacceptable

    Time frame: during surgery, during reduction of the joint

  4. Surgical conditions for assessment of joint kinetics on a four-grade numeric scale

    Excellent - good but not optimal - poor but acceptable - unacceptable

    Time frame: during surgery, after reduction of the joint

06

Study locations

1 site
  • AZ Maria Middelares
    Gent, Oost-Vlaanderen 9000, Belgium
07

References and documents

Individual participant data

Plan to share: Undecided — scores of surgical conditions patient-reported pain scores data about surgery time

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03369782
Lead sponsor
Algemeen Ziekenhuis Maria Middelares
Responsible party
Dr. Alain Kalmar, MD, PhD (Staff Anesthetist, Algemeen Ziekenhuis Maria Middelares) — Principal investigator
First posted
Dec 12, 2017
Start date
Dec 15, 2017 (estimated)
Primary completion
Apr 30, 2018 (estimated)
Completion
May 31, 2018 (estimated)
Last update
Mar 12, 2019

Study contacts

Alain F Kalmar, MD, PhD, MSc
principal investigator · Maria Middelares Hospital

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
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