Modern Myorelaxation Procedure and Reversal of Neuromuscular Blockade With General Anesthesia for Caesarean Section
Condition: Caesarean Section; Pregnancy
Study type: Interventional
Phase: Phase 4

Summary: 
      The project aims to introduce into clinical practice for Caesarean section conducted under
      general anesthesia with the rapid induction myorelaxation with rocuronium and the reversal of
      neuromuscular blockade by using sugammadex. The aim is to demonstrate at least the same
      efficiency and confirm the safety of the procedure for both mother and newborn compared with
      older procedure.
    

Detailed description: 
      Project "Modern myorelaxation procedure and reversal of neuromuscular blockade during general
      anesthesia for caesarean section" aims to introduce in other indications for rapid induction
      of general anesthesia common and safe, alternative method of combining short-acting
      intravenous anesthetics propofol and fast-onset non-depolarizing muscle relaxant rocuronium
      into the clinical practice and demonstrate the efficacy and safety in this indication. At the
      same time to demonstrate the benefits of using modern reversal of neuromuscular blockade by
      sugammadex in termination the caesarean section under general anesthesia. Both procedures
      will be monitored by clinical observation, monitoring instrumentation and laboratory
      examination of mother and fetus (newborn) in various stages of peripartal period. The main
      benefit of this procedure will be in particular risk groups of mothers which are indicated by
      Caesarean Section while neuraxial blockade is contraindicated.
    

Intervention name(s): Rocuronium + sugammadex; Succinylcholine + Neostigmine
Intervention type(s): Drug; Drug
Intervention description(s): Administration of rocuronium 1 mg/kg, intubation at decrease in Single Twitch to 10% of baseline event. by the disappearance of visible spikes event. in the 60th seconds after administration of muscle relaxants. Anesthesia with sevoflurane according to the MAC, neuromuscular blockade TOF count at 1-2.At the end of operation at PTC 1-2 sugammadex 4 mg/kg, at the TOF count 1-2, sugammadex 2 mg/kg, in the case of failure to achieve these values the anesthesiologist will wait until the minimum value of PTC 1-2 will be achieved. In can not intubate can not ventilate, and the failure of the introduction of laryngeal masks sugammadex 16mg/kg, immediately following the discovery of this fact and wait for the recovery of muscle strength. Time to recovery is recorded.; 1mg/kg succinylcholine iodide, intubation after decrease in Single Twitch to 10% of baseline event. after the disappearance of visible fasciculation event. in the 60th seconds after administration of muscle relaxants. Anesthesia with sevoflurane according to the MAC, at the moment of 20-30% of the original value of Single Twitch rocuronium 0.3 mg / kg, maintaining TOF Count at 1-2.At the end of operation at TOF Count 1-2 atropine 0.01 mg/kg and neostigmine 0.03 mg/kg. If TOF not 1-2 wait.In can not intubate can not ventilate, wait for the spontaneous recovery. Time to recovery of muscle strength is recorded.
Intervention MeSH terms: Rocuronium; Succinylcholine; Neostigmine
Allocation: Randomized
Intervention model: Factorial Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: caesarean section; rocuronium; sugammadex