The Impact of Quantitative Neuromuscular Monitoring in the PACU on Residual Blockade and Postoperative Recovery
| Status: | Recruiting |
|---|---|
| Conditions: | Neurology, Neurology |
| Therapuetic Areas: | Neurology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 8/23/2018 |
| Start Date: | August 2013 |
| End Date: | September 2019 |
| Contact: | Edward Sherwood, M.D. |
| Email: | edward.r.sherwood@Vanderbilt.Edu |
| Phone: | 615-322-2564 |
Neuromuscular blocking drugs (NMBDs) provide anesthesiologists with powerful intraoperative
tools, but their use carries the potential risk of serious postoperative complications.
NMBD-induced muscle weakness that lingers into the postoperative period, known as
postoperative residual curarization (PORC), is present in as many as 40% of all patients that
receive neuromuscular blocking agents. The Post Anesthesia Care Unit will be introducing
monitoring as part of standard of care. This study will collect data about patients who
receive NMBDs and examine the impact of monitoring on incidences of PORC.
Our study is designed to test the following hypotheses:
Hypothesis 1: The initiation of quantitative TOF monitoring as part of the standard PACU
entry evaluation will change practitioner behavior in a manner that decreases the incidence
of PORC in surgical patients at VUMC.
Hypothesis 2: The initiation of the routine TOF monitoring program will decrease the
incidence of short- and long-term postoperative complications at VUMC.
tools, but their use carries the potential risk of serious postoperative complications.
NMBD-induced muscle weakness that lingers into the postoperative period, known as
postoperative residual curarization (PORC), is present in as many as 40% of all patients that
receive neuromuscular blocking agents. The Post Anesthesia Care Unit will be introducing
monitoring as part of standard of care. This study will collect data about patients who
receive NMBDs and examine the impact of monitoring on incidences of PORC.
Our study is designed to test the following hypotheses:
Hypothesis 1: The initiation of quantitative TOF monitoring as part of the standard PACU
entry evaluation will change practitioner behavior in a manner that decreases the incidence
of PORC in surgical patients at VUMC.
Hypothesis 2: The initiation of the routine TOF monitoring program will decrease the
incidence of short- and long-term postoperative complications at VUMC.
Neuromuscular blocking drugs (NMBDs) provide anesthesiologists with powerful intraoperative
tools, but their use carries the potential risk of serious postoperative complications.
NMBD-induced muscle weakness that lingers into the postoperative period, known as
postoperative residual curarization (PORC), is present in as many as 40% of all patients that
receive neuromuscular blocking agents. Physiological data suggest that PORC impairs normal
respiratory function, and compelling evidence suggests PORC impairs clinical recovery in the
immediate postoperative period and prolongs PACU length of stay. However, despite the
widespread use of NMBDs and the frequent occurrence of PORC, limitations in the literature
prevent an understanding of their full impact on clinical outcomes. This study will collect
data about patients who receive NMBDs and examine the impact of monitoring on incidences of
PORC.
The incidence of PORC and postoperative complications after the introduction of monitoring in
the PACU will be determined by measuring TOF ratios and tracking the postoperative outcomes
in the surgical patients over time.
tools, but their use carries the potential risk of serious postoperative complications.
NMBD-induced muscle weakness that lingers into the postoperative period, known as
postoperative residual curarization (PORC), is present in as many as 40% of all patients that
receive neuromuscular blocking agents. Physiological data suggest that PORC impairs normal
respiratory function, and compelling evidence suggests PORC impairs clinical recovery in the
immediate postoperative period and prolongs PACU length of stay. However, despite the
widespread use of NMBDs and the frequent occurrence of PORC, limitations in the literature
prevent an understanding of their full impact on clinical outcomes. This study will collect
data about patients who receive NMBDs and examine the impact of monitoring on incidences of
PORC.
The incidence of PORC and postoperative complications after the introduction of monitoring in
the PACU will be determined by measuring TOF ratios and tracking the postoperative outcomes
in the surgical patients over time.
Inclusion Criteria:
- Surgical patients > 18 years of age
- Received one or more NMBDs during surgery
- Surgery took place during the first 120 days following the introduction of TOF
monitoring in the PACU
Exclusion Criteria:
- Surgical patients < 18 years of age
- Received no NMBDs during surgery
- Transfer from the OR to the PACU was delayed (by high PACU volume, for example)
- Had a procedure or has a preexisting condition that prevents accurate monitoring
We found this trial at
1
site
1211 Medical Center Dr
Nashville, Tennessee 37232
Nashville, Tennessee 37232
(615) 322-5000
Principal Investigator: Edward Sherwood, M.D.
Phone: 615-322-2564
Vanderbilt Univ Med Ctr Vanderbilt University Medical Center (VUMC) is a comprehensive healthcare facility dedicated...
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