Muscle Relaxation for Short Procedures

Study Overview
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Brief Summary
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Succinylcholine is commonly used for neuromuscular relaxation for short procedures such as rigid bronchoscopy. A more modern alternative is the application of low-dose rocuronium, reversed by low-dose sugammadex. The investigators compare the intubating conditions, incidence of postoperative myalgia (POM), as well as patient satisfaction for these two muscle relaxants.

Official Title
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Comparing Intubating Conditions and Patient Satisfaction Using Succinylcholine or Low-dose Rocuronium for Rigid Bronchoscopy: A Randomized Study

Conditions
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Sore Throat, Intubating Conditions, Fasciculations, Postoperative Myalgia, Patient Satisfaction

Intervention / Treatment
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* Drug: Succinylcholine
* Drug: Rocuronium/Sugammadex
* Drug: Rocuronium


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age > 18 yr scheduled for elective rigid bronchoscopy Exclusion Criteria: known neuromuscular disease significant hepatic or renal dysfunction family history of malignant hyperthermia known allergy to one of the drugs used in this protocol pregnancy or breastfeeding

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Succinylcholine<br>Patient received succinylcholine as a muscle relaxant(0.5 mg /kg)for induction of anaesthesia for rigid bronchoscopy. | Drug: Succinylcholine<br>* Anaesthesia was induced and maintained with propofol (1-2 mg/kg) and remifentanil (0.5 µg/kg). The study arm was immobilized and a dual electrode for peripheral nerve stimulation was placed over the ulnar nerve near the wrist. Neuromuscular monitoring was performed with accelerometry.The patients received succinycholine according to the study group.<br>|
| Active Comparator: Rocuronium/Sugammadex<br>Patient received rocuronium (0.25 mg/ kg) as muscle relaxant for induction of anaesthesia for rigid bronchoscopy, at the end of procedure rocuronium was reversed with sugammadex (0.5mg/kg.) | Drug: Rocuronium/Sugammadex<br>* Anaesthesia was induced and maintained with propofol (1-2 mg/kg) and remifentanil (0.5 µg/kg). The study arm was immobilized and a dual electrode for peripheral nerve stimulation was placed over the ulnar nerve near the wrist. Neuromuscular monitoring was performed with accelerometry.The patients received rocuronium/sugammadex according to the study group.<br>|
| Active Comparator: Rocuronium<br>Patients received rocuronium (0.25 mg /kg)as muscle relaxant for induction of anaesthesia for rigid bronchoscopy. | Drug: Rocuronium<br>* Anaesthesia was induced and maintained with propofol (1-2 mg/kg) and remifentanil (0.5 µg/kg). The study arm was immobilized and a dual electrode for peripheral nerve stimulation was placed over the ulnar nerve near the wrist. Neuromuscular monitoring was performed with accelerometry.The patients received rocuronium according to the study group.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Intubating condition | scoring system proposed for Good Clinical Research Practice using the following variables: conditions of inserting rigid bronchoscope, vocal cord position, and coughing | After induction of general anaesthesia (after 3-5 minutes) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Fasciculations | Fasciculations were graded by the investigator on the following four-point scale 0 = no fasciculations = mild, fine fasciculations of the eyes, neck, face or fingers, without limb movement = moderate fasciculations occurring at more than two sites, or obvious limb movement = vigorous or severe, sustained and widespread fasciculations in the trunk and limbs | After application of the neuromuscular blocking agent (after 3-5 min) | 
| Postoperative Myalgia (POM) | The severity of POM was measured using a four-point scale 0 = no myalgia = minor pain limited to one area of the body = muscle pain or stiffness noticed spontaneously by the patient, which may have required analgesic therapy = generalized, severe, or incapacitating discomfort | 72 Hours after Intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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succinylcholine, rocuronium, sugammadex, Intubating Conditions, short Procedures