Remifentanil Without Muscle Relaxant for Thoracotomy

• Status: Completed
• Trial end date: 2014-03-01
• Target enrollment: 0
• Participant gender: All

Summary

Although the administration of muscle relaxation is essential standard of care for thoracic procedures, it could cause long-reversal times and postoperative residual curarization (PORC) increasing length of post-anesthesia care unit (PACU) stay and hospital costs. Sugammadex offers new perspectives to reduce the incidence of PORC. Unfortunately it is not available in many countries because of its significantly high cost. We hypothesized that the use of target-controlled remifentanil infusion (TCI) with the non-muscle relaxant (NMR) would be associated with comparable surgical conditions and reduced total costs compared with the use of neuromuscular blockers during thoracotomy.

After ethical approval, 66 patients scheduled for elective thoracotomy under sevoflurane anesthesia with TCI remifentanil will be included in this prospective, randomized, single-blind, controlled study.

Patients will be randomly assigned to receive cisatracurium or saline (n = 33 for each group) throughout the procedure. Laryngoscopy and intubating conditions, intraoperative modified thoracic surgery rating scale (Table below), incidence of light anesthesia, and use of vasopressors and anesthetics, clinical recovery, incidence of PORC, PACU and hospital stays, and total costs will be recorded.

• Phase: Phase 2
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Dammam University
• Treatments: Cisatracurium; Remifentanil

Criteria

Inclusion Criteria:

• American Society of Anesthesiologists physical class (II-III)

• elective open thoracotomy

Exclusion Criteria:

• New York Heart Association class> II)

• Forced vital capacity < 50% of the predicted values

• Forced expiratory volume in 1 second < 50% of the predicted values

• Hepatic diseases

• Renal diseases.

• Reactive airways.

• Neuromuscular diseases.

• Asthma

• Pregnancy

• Increased risk of regurgitation

• Anticipated difficult intubation

• Body mass index >35 kg/m2

• Electrolytes abnormalities

• Acid base abnormalities

• Repeat surgery

• history of head and neck surgery

• Preoperative circulatory support

• Preoperative ventilatory support

• Medications affecting the neuromuscular junctions

• Family history of malignant hyperthermia

• Allergy to any of the study drugs