Influence of Profound Muscle Relaxation on Muscle Trauma and Postoperative Pulmonary Function

Study Overview
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Brief Summary
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Although deep anesthesia can produce skeleton muscle relaxation,unnecessary deep anesthesia often had adverse cardiac effects and was related to 2-year mortality in cancer patients.The use of muscle relaxants allowed the depth of anesthesia to be optimized.However, for many anesthesiologists,in fear of residual postoperative neuromuscular blockade,intraoprative administration of muscle relaxants had to be minimized in spite of poor surgical conditions. This study, however, is designed to test the hypothesis that profound neuromusclular blockade reduces muscle trauma caused by self-retaining retractor and thus cut down postoperative analgesic requirement.On the other hand,profound muscle relaxation can decrease postoperative diaphragmatic dysfunction and abdominal muscle trauma, which can improve postoperative pulmonary function.

Conditions
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Profound Muscle Relaxation, Muscle Trauma, Postoperative Analgesic Demand, Postoperative Pulmonary Function

Intervention / Treatment
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* Drug: profound neuromuscular blockade


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ASA 1 2,scheduled to undergo upper abdominal surgery by midline incision Exclusion Criteria: neuromuscular disorder history of malignant hyperthemia allergy to medications used during general anesthesia

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 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: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: conventional neuromuscular blockade<br>No rocuronium will be administered intraoperatively unless there is surgeons' complain or patients movement | |
| Active Comparator: optimal neuromuscular blockade<br>Rocuronium dose will be infused to maintain depth of NMB at TOF count 1 intraoperatively | Drug: profound neuromuscular blockade<br>* Rocuronium dose will be infused to maintain a depth of NMB to PTC 1 2 intraoperatively<br>|
| Experimental: profound neuromuscular blockade<br>Rocuronium dose will be infused to maintain a depth of NMB to PTC 1 2 intraoperatively | Drug: profound neuromuscular blockade<br>* Rocuronium dose will be infused to maintain a depth of NMB to PTC 1 2 intraoperatively<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| degree of muscle trauma | serum CK | 72h postoperatively | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| postoperative analgesic requirement | consumption of morphine | 7days postoperatively | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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profound muscle relaxation, muscle trauma, postoperative analgesic demand, postoperative pulmonary function