Low Dose Mivacurium vs. Low Dose Succinylcholine for Rigid Bronchoscopy

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 alternative is the application of low dose mivacurium, reversed with neostigmine. The investigators compare the intubating conditions, incidence of postoperative myalgia (POM), patient satisfaction and the postoperative performance with respiration exercise device for these two muscle relaxants.

Conditions
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Intubating Conditions, Performance With Respiratory Exercise Device, Postoperative Myalgia

Intervention / Treatment
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* Drug: Succinylcholine
* Drug: Mivacurium


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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No

Study Plan
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How is the study designed?
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Design Details

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


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Succinylcholine<br>Patient receive succinylcholine as a muscle relaxant (0,5mg/kg) after induction of general anaesthesia for rigid bronchoscopy. | Drug: Succinylcholine<br>* Anaesthesia was induced and maintained with propofol(1-2mg/kg and 5mg/kg/h) and remifentanil (1µg/kg and 0,2µ/kg/min). The study arm is immobilized and a dual electrode for peripheral nerve stimulation is placed over the ulnar nerve near the wrist. Neuromuscular monitoring is performed with accelerometry. the patients receive the muscle relaxant according to the study group.<br>* Other names: Rigid Bronchoscopy;|
| Active Comparator: Mivacurium<br>Patients receive mivacurium (0,08mg/kg) as a muscle relaxant after induction of general anaesthesia for rigid bronchoscopy. At the end of the procedure and a twitch of 25% mivacurium was reversed with neostigmine (50 microg/kg) and atropin (10 microg/kg) | Drug: Mivacurium<br>* Anaesthesia was induced and maintained with propofol(1-2mg/kg and 5mg/kg/h) and remifentanil (1µg/kg and 0,2µ/kg/min). The study arm is immobilized and a dual electrode for peripheral nerve stimulation is placed over the ulnar nerve near the wrist. Neuromuscular monitoring is performed with accelerometry. the patients receive the muscle relaxant according to the study group.<br>* Other names: Rigid Bronchoscopy;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Intubating condition | For measuring the intubation conditions the scoring system proposed for Good clinical Research Practice using the following variables is used: conditions of inserting the 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 |
| --- | --- | --- |
| Postoperative Myalgia | 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 | 
| postintervention performance with a expiration exercise device | The performance with a respiration exercise device, which measures the expirational volume, before and after intervention. | 72 hours after intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Succinylcholine, Mivacurium, Rigid Bronchoscopy, Intubating conditions, Short Procedure