Reversal of Neuromuscular Blockade During the General Anaesthesia

Study Overview
=================
Brief Summary
-----------------
There are individual reports indicating that after the reversal of nondepolarizing neuromuscular blockade with neostigmine, some patients starts to relax spontaneously again after the tof ratio has already recovered to the safe level (>90%). The mechanism behind this in not well understood, and the incidence of the phenomenon is unclear. In this study the investigators try to determine the incidence of the aforementioned postrecovery relaxation.

Detailed Description
-----------------
There are individual reports indicating that after the reversal of nondepolarizing neuromuscular blockade with neostigmine, some patients start to relax spontaneously again after the tof ratio has already recovered to the safe level (90%). The mechanism behind this in not well understood and the incidence of the phenomenon is unclear. The aim of this study is to monitor the reversal of rocuronium induced neuromuscular blockade with neostigmine. The neuromuscular blockade is monitored with train of four stimulations using electromyography. After the reversal agent is given and train of four ratio has recovered to the level of 90%, the neuromuscular blockade is monitored another 30min to see if tof ratio starts to spontaneously fall again under the 90%. If aforementioned postrecovery relaxation happens, the investigators are able to calculate the incidence of the phenomenon.

Official Title
-----------------
Reversal of Neuromuscular Blockade During the General Anaesthesia

Conditions
-----------------
Neuromuscular Blockade

Intervention / Treatment
-----------------
* Drug: Neostigmine, Combinations


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Elective surgery requiring general anaesthesia Surgery is assumed to last more than 45 minutes Body mass index less than 35kg/ m² Exclusion Criteria: Disease of central nervous system Trauma of central nervous system Disease affecting peripheral nervous system Medication affecting peripheral nervous system

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

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Interventional Model Description: Single group with same study protocol to asses the incidence of postrecovery relaxation
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Study group<br>Single arm and everyone gets the same treatment according the protocol | Drug: Neostigmine, Combinations<br>* All patients have neostigmine induced recovery of neuromuscular block.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of postrecovery relaxation | Number of patients (if any) with postrecovery relaxation divided by a number of all patients | 30 minutes | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
neuromuscular blockade, neostigmine, muscle relaxation, train of four, rocuronium