The Influence of Neuromuscular Reversal on Neurological Physical Exam Time in Lumbar Neurosurgical Cases.

Study Overview
=================
Brief Summary
-----------------
Neurological physical exam is a very important outcome that should be evaluated as soon as possible after every lumbar procedures. The aim of this study was to evaluate the neurological physical examination time after lumbar procedures.

Detailed Description
-----------------
Neurological physical exam is a very important outcome that should be evaluated as soon as possible after every lumbar procedures. By that early postoperative neurological complications can be revealed and early interventions planned. The aim of this study was to evaluate the neurological physical examination time after lumbar procedures. Two routinely used different reversal agents (neostigmine or sugammadex) were compared according reversal times and muscle strength on PACU admission.

Official Title
-----------------
The Influence of Neuromuscular Reversal With Neostigmine or Sugammadex on Neurological Physical Exam Time in Lumbar Neurosurgical Cases.

Conditions
-----------------
Neurological Complication

Intervention / Treatment
-----------------
* Diagnostic Test: Neurological physical exam


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Lumber surgery ASA I-II Elective surgery Exclusion Criteria: Emergency cases Age lower than 18 Age higher than 65 Patient with existing neurological deficit Patient with existing renal insufficiency

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

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

Accepts Healthy Volunteers
-----------------
No

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

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Group S<br>Group S: Group sugammadex Patients in this group received sugammadex at the end of the surgery, as neuromuscular reversal agent. Neurological physical exam time was recorded. | Diagnostic Test: Neurological physical exam<br>* Neurological physical exam is performed in all patients at the OR table, immediately after the operation.<br>|
| Group N<br>Group N: Group Neostigmine Patients in this group received neostigmine at the end of the surgeryas neuromuscular reversal agent. Neurological physical exam time was recorded. | Diagnostic Test: Neurological physical exam<br>* Neurological physical exam is performed in all patients at the OR table, immediately after the operation.<br>|

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

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Neurological physical examination time | Neurological physical examination time | postoperative first 30 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Muscle strength at PACU transfer | Muscle strength at PACU transfer (evaluated with a 5 point scale) 0/5: no contraction in muscles 1/5: muscle flicker but no movement 2/5: movement possible bıt not against gravity (test the joint in its horizontal plane) 3/5: moment possible against gravity but not against resistance by the examiner 4/5: movement possible against resistance by the examiner 5/5: normal strength | postoperative first 60 minutes |