Sugammadex and Quantitative Monitoring in Fast-Track Anesthesia During Liver Transplantation

Study Overview
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Brief Summary
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The purpose of this research is to estimate the frequency of postoperative lasting muscle weakness in patients receiving Sugammadex after undergoing liver transplant surgery by using electromyographic device (EMG), such as TetraGraph.

Official Title
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The Role of Sugammadex and Quantitative Monitoring in Fast-Track Anesthesia During Liver Transplantation

Conditions
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Liver Transplant Surgery

Intervention / Treatment
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* Other: TetraGraph on dominant hand
* Other: TetraGraph on non-dominant hand


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients willing to participate and provide an informed consent. Patients undergoing primary liver transplantation. Exclusion Criteria: Patients with unilateral disorders, such as stroke, carpal tunnel syndrome, broken wrist with nerve damage, Dupuytren contracture, or any similar wrist injury. Patients with systemic neuromuscular diseases such as myasthenia gravis. Patients with a known history of cerebrovascular accident (CVA). Patients undergoing repeat liver transplantation or concomitant pancreas/kidney transplantation at the time of liver transplantation. Patients admitted to the intensive care unit prior to liver transplantation.

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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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| TetraGraph monitoring on dominant hand<br>Patients receiving sugammadex after undergoing liver transplantation with quantitative monitoring as standard of care | Other: TetraGraph on dominant hand<br>* Using standard of care TetraGraph device on dominant hand<br>|
| TetraGraph monitoring on non-dominant hand<br>Patients receiving sugammadex after undergoing liver transplantation with quantitative monitoring as standard of care | Other: TetraGraph on non-dominant hand<br>* Using standard of care TetraGraph device on non-dominant hand<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of postoperative residual weakness in the recovery room | Number of patients to experience postoperative residual weakness after receiving Sugammadex as standard of care for liver transplant surgery. Postoperative residual weakness is defined as train-of-four <0.9 measured by an EMG device placed on the thumb which is also part of standard of care for intraoperative assessment of muscle weakness. | Approximately 10 minutes of surgery recovery period | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| ICU Admission | Number of patients to require ICU admission following liver transplantation | 30 days | 
| Hospital length of stay | Total number of days patients are admitted to the hospital following liver transplantation | 30 days | 
| Postoperative pulmonary complications | Number of postoperative pulmonary complications defined as pneumonia and respiratory failure | 30 days |