Use of Neuromuscular Blocking Agents and Neuromuscular Monitoring in 7 Danish Teaching Hospitals

Study Overview
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Brief Summary
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Aim: To explore the frequency of use of objective neuromuscular monitoring for assessment of depth of neuromuscular blockade in general anaesthesia the incidence of residual neuromuscular blockade, and the timing of reversal of the neuromuscular blockade at the end of anaesthesia. We will collect data from 7 Danish anaesthesia departments, using data from the Anaesthesia Information Management System (AIMS).

Official Title
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Use of Neuromuscular Blocking Agents and Neuromuscular Monitoring in 7 Danish Teaching Hospitals - a Cross-sectional Study

Conditions
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Neuromuscular Blockade

Intervention / Treatment
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* Drug: Rocuronium
* Drug: Succinylcholine
* Drug: Cisatracurium
* Drug: Mivacurium
* Device: Objective neuromuscular monitoring (acceleromyography)
* Drug: Sugammadex
* Drug: Neostigmine


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients who received general anaesthesia with neuromuscular blockade in one of the 7 hospitals providing data for the study in the last 18 months up until the time of data collection

Ages Eligible for Study
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Minimum Age: 15 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Eligible patients<br>Patients ≥15 years of age who received general anaesthesia with neuromuscular blockade in the last 18 months up until the time of data collection. Patients, who are eligible more than once, i.e. undergoing general anaesthesia on more than one occasion, will be included in the analyses as a case for every general anaesthetic received. | Drug: Rocuronium<br> <br> Drug: Succinylcholine<br> <br> Drug: Cisatracurium<br> <br> Drug: Mivacurium<br> <br> Device: Objective neuromuscular monitoring (acceleromyography)<br> <br> Drug: Sugammadex<br> <br> Drug: Neostigmine<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Participants With and Without Objective Neuromuscular Monitoring (Acceleromyography) in Cases Receiving a Non-depolarizing Neuromuscular Blocking Agent (NMBA) (Yes/no) |  | in the period from induction of anaesthesia to termination of anaesthesia, usually 2 hours | 
| Number of Participants With and Without Objective Neuromuscular Monitoring (Acceleromyography) in Cases Receiving a Depolarizing NMBA (Succinylcholine) (Yes/no) |  | in the period from induction of anaesthesia to termination of anaesthesia, usually 2 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Last Recorded Train-of-four (TOF) Ratio Before Tracheal Extubation or Removal of Supraglottic Airway Device in Patients Receiving a Non-depolarizing NMBA | The train-of-four (TOF) ratio is the ratio between the last and first measurements after four stimuli of the ulnar nerve at 2 Hz. The ratio should be at least 0.9 before tracheal extubation. | in the period from induction of anaesthesia to termination of anaesthesia, usually 2 hours | 
| Number of Participants With and Without Administration of Sugammadex in Cases Receiving a Non-depolarizing NMBA (Yes/no) |  | in the period from induction of anaesthesia to discharge from the post-anaesthesia care unit, usually 5 hours | 
| Number of Participants With and Without Administration of Neostigmine in Cases Receiving a Non-depolarizing NMBA (Yes/no) |  | in the period from induction of anaesthesia to discharge from the post-anaesthesia care unit, usually 5 hours | 
| Time in Minutes From Tracheal Extubation or Removal of Supraglottic Airway Device to Discharge From Post-anaesthesia Care Unit in Cases Involving a Non-depolarizing NMBA With and Without Neuromuscular Monitoring, Respectively |  | in the period from induction of anaesthesia to discharge from the post-anaesthesia care unit, usually 180 minutes | 
| Number of Participants With and Without Mild Oxygen Desaturation (<90%, But >80%) in Cases Receiving a Non-depolarizing NMBA |  | in the period between tracheal extubation or removal of supraglottic airway device and discharge from post-anaesthesia care unit, assessed up to 24 hours | 
| Number of Participants With and Without Severe Oxygen Desaturation (<80%) in Cases Receiving a Non-depolarizing NMBA |  | in the period between tracheal extubation or removal of supraglottic airway device and discharge from post-anaesthesia care unit, assessed up to 24 hours | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Residual nerve blockade, Neuromuscular monitoring, Residual curarization, Neuromuscular blocking agents