Functional Respiratory Imaging After Neostigmine or Sugammadex
Status:
Completed
Trial end date:
2015-04-01
Target enrollment:
Participant gender:
Summary
The use of neuromuscular blocking agents (NMBAs) is still associated with postoperative
pulmonary complications. The investigators rely on acceleromyography (AMG) of a peripheral
nerve/muscle to assess the patients' breathing capability at the end of surgery. It is
possible that respiratory complications after surgery (e.g. desaturation and atelectasis) are
related to the lack of diaphragm activity.
A previous trial by our study group links the use of sugammadex, a novel selective relaxant
binding agent (SRBA) for reversal of neuromuscular blockade, to an increase in diaphragm
electrical activity, compared to reversal with neostigmine. Our hypothesis is that by making
nicotinergic acetylcholine receptors free from rocuronium in the diaphragmatic neuromuscular
junctions, instead of increasing the amount of acetylcholine (like neostigmine does),
sugammadex will result in a better neuromuscular coupling. This may have its subsequent
effects on the central control of breathing, influencing the balance between intercostal and
diaphragm activity.
The investigators now propose a study in rats, where the investigators will use Functional
Respiratory Imaging (FRI, property of FluidDA n.v., Groeningenlei 132, B-2550 Kontich) to
assess regional lung ventilation after sugammadex, neostigmine or spontaneous reversal. The
images obtained through micro-CT scans allow us to accurately reconstruct airway morphology
in the free-breathing rat. It will provide us with new insights into breathing physiology
after reversal of neuromuscular blockade.