Rocuronium vs Cis-atracurium: Do Rocuronium Still 'ROCKS' In Coronary Artery Bypass Grafting

Study Overview
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Brief Summary
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The current trend in most cardiac surgeries was to use rocuronium as it provides faster recovery in train-of-four ratio compared to other aminosteroid non-depolarising neuromuscular blocker. However, as most cardiac centres' standard of care does not perform any neuromuscular monitoring nor antagonism of neuromuscular blockade effect, residual neuromuscular blockade could potentially be the key to delayed extubation. As such, Cis-atracurium's organ-independent Hofmann elimination could be in favour.

Official Title
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Rocuronium vs Cis-atracurium: Do Rocuronium Still 'ROCKS' In Coronary Artery Bypass Grafting

Conditions
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Neuromuscular Blockade, Postoperative Pulmonary Atelectasis, Postoperative Pulmonary Complication, Coronary Artery Disease, Coronary Artery Bypass Grafting, Hypothermic Cardiopulmonary Bypass

Intervention / Treatment
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* Drug: Rocuronium Bromide 10 MG/ML
* Drug: Nimbex 10 MG in 5 ML Injection


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All patients that undergo general anaesthesia for CABG surgery requiring neuromuscular blockade of either rocuronium or cis-atracurium Exclusion Criteria: Recent history of pulmonary infection four weeks before surgery Exposed to both neuromuscular blockade within 24 hours perioperatively Patients intubated or on tracheostomies pre-operatively Any missing or incomplete data

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 |
| --- | --- |
| Rocuronium<br>Rocuronium 1mg/kg to be given at induction of anaesthesia and another 1mg/kg would be given when the patient is on hypothermic cardiopulmonary bypass | Drug: Rocuronium Bromide 10 MG/ML<br>* Comparative<br>* Other names: Esmeron;|
| Cis-atracurium<br>Cis-atracurium 0.2mg/kg to be given at induction of anaesthesia and another 0.2mg/kg would be given when the patient is on hypothermic cardiopulmonary bypass | Drug: Nimbex 10 MG in 5 ML Injection<br>* Comparative<br>* Other names: Cis-atracurium;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of postoperative pulmonary complication | Which neuromuscular relaxant is associated with lesser postoperative pulmonary complication | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Ventilation hours in ICU | Ventilation hours from ICU admission from OR to extubation | 6 months | 
| Requirements for Non-invasive ventilation | NIV duration | 6 months | 
| Incidence of postoperative atrial fibrillation | Incidence of postoperative atrial fibrillation | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Neuromuscular Blockade, Postoperative Pulmonary Atelectasis, postoperative pulmonary complication, Coronary Artery Disease, coronary artery bypass grafting, hypothermic cardiopulmonary bypass, rocuronium, cis-atracurium