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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT03034577
Registration number
NCT03034577
Ethics application status
Date submitted
17/01/2017
Date registered
27/01/2017
Titles & IDs
Public title
Deep Neuromuscular Block for Laparoscopic Surgery
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Scientific title
A Randomized Trial of Deep Neuromuscular Blockade Reversed With Sugammadex Versus Moderate Neuromuscular Block Reversed With Neostigmine, on Postoperative Quality of Recovery
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Secondary ID [1]
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2016.343
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Universal Trial Number (UTN)
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Trial acronym
DEEPBLOCK
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Laparoscopy
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Anesthesia Recovery Period
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Condition category
Condition code
Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Sugammadex
Treatment: Drugs - Neostigmine
Active comparator: ModNMB - Moderate Neuromuscular block: participants will receive moderate neuromuscular blockade with rocuronium aiming for TOF 0-2 twitches, with neostigmine reversal when the TOF at least 3 twitches. The depth of neuromuscular block may be reduced after completion of the majority of surgical excision to TOF 3 or more
Neostigmine
Active comparator: DeepNB - Deep Neuromuscular block: participants will receive DNB aiming for a post tetanic count of 1-2, which will be maintained until removal of the laparoscopic ports, with reversal using sugammadex
Treatment: Drugs: Sugammadex
Reversal of neuromuscular block Sugammadex dosage will be adjusted to body weight and PTC/TOF count at the time of reversal, and not administered until PTC at least 1. Dosage will be 4mg/kg if TOF = 0 and PTC = 1; and 2 mg/kg if TOF =1.
Treatment: Drugs: Neostigmine
Neostigmine 50 micrograms/kg coupled with atropine 20 micrograms/kg or glycopyrrolate 5 micrograms/kg, to a maximum dose of neostigmine of 5.0 mg. The neostigmine should not be administered until the TOF has at least 3 twitches present.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Percentage of Patients Recovered Cognitively at 1 Week
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Assessment method [1]
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The primary outcome will be the cognitive domain at 1 week after surgery, when it is expected that most of the acute inflammation will have resolved, and analgesia requirements minimal.
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Timepoint [1]
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1 week
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Secondary outcome [1]
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Percentage of Patients Recovered in All Domains of the Postoperative Quality of Recovery Scale at 3 Months After the Operation
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Assessment method [1]
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Recovery for all domains and within domains of the PostopQRS scale at the other time points of measurement (15 minutes, 40 minutes 1 day, 3 days, 1 and 2 weeks, and 3 months following cessation of anesthesia). The domains of recovery are physiological, nociceptive, emotive activities of daily living, cognitive and overall patient perspective.
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Timepoint [1]
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3 months
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Secondary outcome [2]
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Number of Participants With Full Reversal of Neuromuscular Blockade Prior to Extubation
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Assessment method [2]
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Compliance with protocol to ensure deep block or light/moderate block, using the train of four ratio and post tetanic count
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Timepoint [2]
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6 hours
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Secondary outcome [3]
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Duration of Anesthesia From Induction to Cessation of the Anesthetic
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Assessment method [3]
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Duration of Anesthesia from induction to cessation of the anesthetic up to 6 hours
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Timepoint [3]
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Up to 6 hours
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Secondary outcome [4]
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Number of Participants Categorized by Level of Surgical Satisfaction
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Assessment method [4]
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Overall surgical satisfaction using a 1-5 Likert scale (1 = very unacceptable, 2 = unacceptable, 3 = acceptable, 4 = good, 5 = excellent).
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Timepoint [4]
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2 hours
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Secondary outcome [5]
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Duration of Hospital Length of Stay
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Assessment method [5]
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Duration of hospital length of stay following their procedure until hospital discharge
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Timepoint [5]
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3 days
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Eligibility
Key inclusion criteria
1. Adult participants
2. operative gynecological or abdominal surgery
3. receiving general anesthesia
4. Operation expected to exceed1 hour duration
5. Participants must speak sufficient English to answer the survey questions
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Participants undergoing diagnostic laparoscopy only
2. Participants <18 years of age
3. Current pregnancy
4. Known allergy to rocuronium, neostigmine or sugammadex, or desflurane
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 4
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
16/06/2017
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
1/04/2019
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Sample size
Target
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Accrual to date
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Final
350
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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Northpark Private Hospital - Bundoora
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Recruitment hospital [2]
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Melbourne Health - Parkville
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Recruitment hospital [3]
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The Royal Womens Hospital - Parkville
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Recruitment hospital [4]
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Victorian Comprehensive Cancer Centre - Parkville
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Recruitment postcode(s) [1]
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3083 - Bundoora
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Recruitment postcode(s) [2]
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3050 - Parkville
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Funding & Sponsors
Primary sponsor type
Other
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Name
University of Melbourne
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Address
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Country
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Other collaborator category [1]
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Other
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Name [1]
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Melbourne Health
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Address [1]
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Country [1]
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Other collaborator category [2]
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Other
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Name [2]
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Peter MacCallum Cancer Centre, Australia
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Address [2]
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Country [2]
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Other collaborator category [3]
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Other
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Name [3]
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Royal Hospital For Women
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Address [3]
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Country [3]
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Other collaborator category [4]
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Other
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Name [4]
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Northpark Private Hospital
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Address [4]
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Country [4]
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Ethics approval
Ethics application status
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Summary
Brief summary
Trial summary: deep neuromuscular block is proposed as a technique to improve operative conditions for laparoscopy. Early clinical data would suggest that there may also be patient benefits beyond the operative period related to lower intra-abdominal pressure, and improved surgical exposure. In order to safely conduct deep neuromuscular blockade, it is essential to use Sugammadex to reverse the neuromuscular block. Conventional practice is to provide moderate neuromuscular block and reverse with neostigmine. It is not possible to safely reverse deep neuromuscular block using neostogmine, as the majority of block must have worn off for neostigmine to be effective. in order to identify whether deep neuromuscular block improves quality of recovery after surgery, the investigators will conduct a randomised trial of deep versus moderate neuromuscular block, whilst minimising variance in other anaesthetic techniques and drugs used. the outcome measured will be the post-operative quality of recovery over multiple time periods using the Postoperative Quality of Recovery Scale (PostopQRS). 350 patients will be enrolled over 4 centres.
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Trial website
https://clinicaltrials.gov/study/NCT03034577
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Trial related presentations / publications
Boggett S, Chahal R, Griffiths J, Lin J, Wang D, Williams Z, Riedel B, Bowyer A, Royse A, Royse C. A randomised controlled trial comparing deep neuromuscular blockade reversed with sugammadex with moderate neuromuscular block reversed with neostigmine. Anaesthesia. 2020 Sep;75(9):1153-1163. doi: 10.1111/anae.15094. Epub 2020 May 12.
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Public notes
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Contacts
Principal investigator
Name
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Colin Royse, MD
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Address
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University of Melbourne
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Type
Other Details
Attachment
Study protocol
https://cdn.clinicaltrials.gov/large-docs/77/NCT03034577/Prot_000.pdf
Statistical analysis plan
https://cdn.clinicaltrials.gov/large-docs/77/NCT03034577/SAP_001.pdf
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results are available at
https://clinicaltrials.gov/study/NCT03034577