Effect of Sevoflurane on the Onset Characteristics and Intubating Conditions of Rocuronium

Study Overview
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Brief Summary
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This study evaluates the potentiation of muscle relaxation caused by rocuronium by inhalational agent sevoflurane. Half the patients will be ventilated with oxygen ,nitrous oxide and sevoflurane during induction of anaesthesia and half will be ventilated only with oxygen and nitrous oxide.

Detailed Description
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Rocuronium is a non depolarizing muscle relaxant. Inhalational general anaesthetic agents like Sevoflurane have some muscle relaxation effect by depressing the spinal motor neurons. Inhalational anaesthetics also alter the tonic input received from descending modulatory systems from the brain. Deep anaesthesia with inhalational agents may cause some degree of neuromuscular blockade.

Official Title
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Effect of Sevoflurane on the Onset Characteristics and Intubating Conditions of Rocuronium Under Routine Clinical Practice

Conditions
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Muscle Relaxation Caused by Sevoflurane

Intervention / Treatment
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* Drug: Sevoflurane
* Drug: Rocuronium


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: American society of anaesthesiologists physical status 1 and 2 Age between 18-65 Mallampatti classification 1 and 2 Exclusion Criteria: Patients refusal to participate American society of anaesthesiologists physical status 3 and 4 Mallampatti classification 3 and 4 Patients with neuromuscular disorder Patients on medications that affect neuromuscular block Pregnant and lactating patients

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: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: sevoflurane and rocuronium<br>After induction of general anaesthesia, patients in the sevoflurane group were ventilated with fresh gas flow of 5 lites per minute consisting of 66.6% nitrous oxide and 33.3% oxygen with 2% inspired concentration of sevoflurane. After stabilization of end tidal carbondioxide to 30-35 mmHg ,intravenous rocuronium 0.6mg per Kg body weight was injected | Drug: Sevoflurane<br>* Patients were ventilated with 2 % inspired concentration of sevoflurane in a fresh gas flow of 5 litres containing 66.6% nitrous oxide and 33.3% percent of oxygen<br>* Other names: Sevorane;Drug: Rocuronium<br>* rocuronium 0.6mg per kg body weight was given intravenously after induction of anaesthesia<br>* Other names: Esmeron;|
| Active Comparator: rocuronium<br>After induction of general anaesthesia, patients in the control group were ventilated with fresh gas flow of 5 lites per minute consisting of 66.6% nitrous oxide and 33.3% oxygen . After stabilization of end tidal carbondioxide to 30-35 mmHg ,intravenous rocuronium 0.6mg per Kg body weight was injected | Drug: Rocuronium<br>* rocuronium 0.6mg per kg body weight was given intravenously after induction of anaesthesia<br>* Other names: Esmeron;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| intubating condition | Copenhagen Consensus Conference Scale-scale to assess ease of intubation consisting of 5 parameters.laryngoscopy,vocal cord movement,vocal cord position,movement at intubation,coughing at intubation all are judged as poor ,good or excellent.If any parameter has a poor score, it is a clinically unacceptable intubating condition. | 10 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| lag time | time from start of rocuronium injection to first change in single twitch height on neuromuscular monitor | 10 minutes | 
| onset time for maximum relaxation | time from start of rocuronium injection to the disappearance of all four twitches on train of four stimulus on neuromuscular monitor | 10 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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sevoflurane, rocuronium, intubation