The Effect of Sugammadex Versus Neostigmine on Postoperative Pulmonary Complications

Sponsor
Oregon Health and Science University (Other)
Overall Status
Completed
CT.gov ID
NCT02861131
Collaborator
Merck Sharp & Dohme LLC (Industry)
200
1
2
15.1
13.2

Study Details

Study Description

Brief Summary

Substantial respiratory morbidity has been associated with postoperative residual paralysis, which is fairly common after general anesthesia involving a neuromuscular blocking agent. Common practice in United States is to reverse neuromuscular blockade with neostigmine at the end of surgery. A new drug with evidence of more complete neuromuscular reversal has been developed, sugammadex. The objective of this study is to determine if a strategy of rocuronium neuromuscular reversal with sugammadex will reduce the proportion of subjects with any postoperative pulmonary complication, compared to neostigmine.

Condition or Disease Intervention/Treatment Phase
Phase 4

Detailed Description

This study is designed to be an assessor-blinded, randomized, controlled, single center, parallel design trial at Oregon Health and Science University (OHSU) in Portland, Oregon. The investigators will enroll patients ≥ 70 years of age that are mentally competent to consent for anesthesia with a scheduled surgical length of ≥ 180 minutes on Monday through Friday in the South Operating Room Theatre at Oregon Health and Science University.

Subjects will be screened for inclusion in the study on either the day prior or the day of surgery. The initial review will occur by a quick view of the surgical posting sheet for the South Operating Rooms. Subjects undergoing any type of surgery will be eligible as long as neuromuscular paralysis is a component of the planned anesthetic. If subjects initially seem appropriate for inclusion, a more in depth chart review will occur. The research coordinator will approach patients that meet inclusion criteria in the Pre-operative Care Unit. Initially all patients 70 years of age or older will have equal probability of being approached for the study. At the halfway point of the study the investigators will monitor enrollment, and if ahead of schedule, preferentially select older patients in the 2nd half of the study-a group that is more likely to have Postoperative Pulmonary Complications (PPCs).

All subjects that are approached for recruitment will hear a description of the study, reasons for pursuing this research question, options for opting out the research protocol or not completing data collection, and potential risks, advantages, and disadvantages from participating. Subjects that agree to participate in the study will be asked to sign a written informed consent that has been approved by our Institutional Review Board. All subjects that agree to participate in the research study will be given a form describing the research study and providing contact information for the principal investigators. The subject's status in the research project will show up clearly on our medical records in their problem list, until the subject's time of participation is complete. A progress note will be placed in the subject's chart to allow other providers to easily contact study investigators. In addition, an electronic copy of the signed consent will be scanned into the medical records system and a copy of the signed consent will be made available for the subject to take home.

All subjects enrolled will have the following characteristics recorded by the research coordinator: age, sex, weight, body mass index, American Society of Anesthesiologists physical status classification score, creatinine clearance, and Charlson comorbidity index.

Subjects will be allocated to either neuromuscular reversal with sugammadex or neostigmine. Before study activation a sample of 200 sequentially numbered opaque envelopes will be prepared by an investigator not involved in patient recruitment, allocation, consent, or assessment: 100 for the sugammadex arm and 100 for the neostigmine arm. Patient allocation will occur in the operating room when the anesthesia provider notifies the coordinator that reversal is appropriate. At that time the research coordinator will open the lowest remaining numbered free envelope. Group assignment will be determined by a computer generated random number sequence produced in Excel (Redmond, Washington). The random number sequence will be generated by an investigator not involved in either patient enrollment or patient assignment. Reversal of rocuronium neuromuscular blockade (i.e. sugammadex or neostigmine) will be defined in the opened opaque envelope. Once a study subject signs a consent form, a unique number corresponding to the opened opaque envelope will be assigned to that subject. The envelope will not be opened until the anesthesia provider is ready to prepare and administer reversal of neuromuscular blockade. This subject number will never be reused and will remain with the subject for the entirety of the study. No subject will ever be allowed to have more than one unique subject number.

The subject, anesthesia providers, and research coordinator performing consent and recruitment will not be blinded to the study drug. The anesthesiologists will not be blinded for reasons of patient safety. The assessor of PPCs, residual neuromuscular blockade, secondary outcomes, exploratory outcomes, and adverse event accounting will be blinded to study drug and will not be allowed in the operating room during surgery.

All subjects will have standard American Society of Anesthesiologists monitors plus five lead electrocardiogram applied. Additional monitoring needs will be left up the anesthesia team directing patient care. Decisions with regards to induction and maintenance of anesthesia will also be left up to the direction of the anesthesia team with the exception that rocuronium will be mandated for maintenance of neuromuscular blockade. Decisions on when to dose and what quantity of rocuronium should be dosed for maintenance of neuromuscular blockade will be left to the discretion of the anesthesia team in the operating room. The level of neuromuscular blockade will be monitored in the operating room at the adductor pollicis muscle with a basic peripheral nerve stimulator monitor that does not have train-of-four ratio capability. Train-of-four counts will be mandated every 15 minutes, which is our current practice at OHSU. Anesthesia providers will be asked to maintain neuromuscular blockade at a T2 level throughout surgery and reverse neuromuscular blockade at as close to a T2 level as safely possible. Administration of sugammadex or neostigmine will occur into a fast flowing IV that is running wide open. Sugammadex will be dosed at 2 mg/kg and neostigmine will be dosed at 0.07 mg/kg to a maximum of 5 mg. Glycopyrrolate will be co-administered in the neostigmine arm at a dose between 0.1 to 0.2 mg of glycopyrrolate per 1.0 mg of neostigmine administered.

In accordance with standard of practice at OHSU, all subjects will have convective warmers used during the case and subject temperature will be monitored. Ventilation parameters will be left to the discretion of the anesthesia team in the operating room.

A train-of-four ratio will be obtained in all subjects within 5 minutes of arrival to the Post-Anesthesia Care Unit (PACU) with a Train-of-four Watch-SX Acceleromyograph. In order to measure the train-of-four ratio in the PACU the train-of-four watch will be set up and calibrated on the subject upon arrival in the OR, prior to the administration of any neuromuscular blocking agent. The accelerometer sensor will be attached to the subject's thumb. The subject's fingers and forearm adjacent to the thumb attached to the accelerometer sensor will be fixed with tape to an arm board to minimize artifact. Ulnar nerve stimulation of the adductor pollicis muscle will be measured via the Train-of-four watch. As twitch height will vary from subject to subject, a control twitch height value of 100% for the 1 Hz mode will be calibrated after a 5 second, 50 Hz tetanic stimulation. This calibration will be used to obtain a train-of-four ratio upon 5 minutes of arrival to the PACU. A train-of-four ratio of less than 0.9 will be considered residual neuromuscular blockade.

Active monitoring of adverse events (desaturation, hypoxemia, upper airway obstruction, aspiration pneumonitis, bronchospasm, laryngospasm, drug hypersensitivity reaction, and recurarization) will be conducted on an ongoing basis until discharge with daily assessments by the research coordinator and/or principal investigator. Assessment of PACU phase 1 recovery time will occur on Post-operative day (POD) #0 or POD #1. Assessment of hospital length of stay will be assessed within a week of discharge by electronic medical record review. Hospital readmission data will be assessed within 1 to 2 months of hospital discharge. National Surgical Quality Improvement Program (NSQIP) 30-day postoperative risk-adjusted respiratory complications will be assessed and recorded prior to data analysis at the conclusion of patient enrollment and study implementation.

Study Design

Study Type:
Interventional
Actual Enrollment :
200 participants
Allocation:
Randomized
Intervention Model:
Parallel Assignment
Masking:
Single (Outcomes Assessor)
Primary Purpose:
Prevention
Official Title:
The Effect of Sugammadex Versus Neostigmine on Postoperative Pulmonary Complications in Patients 70 Years or Older and Scheduled for 3 Hour or Longer Surgery-A Randomized Controlled Trial
Actual Study Start Date :
Jan 24, 2017
Actual Primary Completion Date :
Apr 30, 2018
Actual Study Completion Date :
Apr 30, 2018

Arms and Interventions

Arm Intervention/Treatment
Experimental: Sugammadex

Sugammadex 2 mg/kg IV once at the end of surgery

Drug: Sugammadex
At the end of the surgical procedure at a depth of neuromuscular blockade after the reappearance of T2 on the train-of-four, Sugammadex will be dosed once at 2 mg/kg through an intravenous line with brisk flow
Other Names:
  • Org 25969
  • Bridion
  • Active Comparator: Neostigmine

    Neostigmine 0.07 mg/kg to a maximum of 5 mg (+ Glycopyrrolate 0.1-0.2 mg per 1 mg of Neostigmine administered) IV once at the end of surgery

    Drug: Neostigmine
    At the end of surgical procedure at a depth of neuromuscular blockade after the reappearance of T2 on the train-of-four, Neostigmine will be dosed once at 0.07 mg/kg to a maximum of 5 mg through an intravenous line with brisk flow. Glycopyrrolate will be administered with Neostigmine at a dose between 0.1 to 0.2 mg of Glycopyrrolate per 1.0 mg of Neostigmine administered.
    Other Names:
  • Prostigmin
  • Vagostigmin
  • Outcome Measures

    Primary Outcome Measures

    1. Number of Participants With a Postoperative Pulmonary Complication [Length of hospitalization, an average of 1 week]

      A composite outcome which includes any of the following: postoperative pneumonia, aspiration pneumonitis, atelectasis, pneumothorax, desaturation/hypoxemia, upper airway obstruction, or acute respiratory insufficiency

    Secondary Outcome Measures

    1. Number of Participants With Residual Neuromuscular Blockade in the PACU [1 day]

      Residual neuromuscular blockade will be defined as a train-of-four ratio < 0.9 taken within 5 minutes of subject arrival in the PACU

    2. PACU Phase 1 Recovery Time [1 day]

      Defined as duration of time required to attain pain control and stable respiratory, haemodynamic, and neurological status

    Other Outcome Measures

    1. Hospital Length of Stay [Length of hospitalization, an average of 1 week]

      Defined as the number of days between hospital admission and discharge

    2. Number of Participants With Hospital Readmission Within 30 Days [Length of hospitalization plus 30 days post-discharge]

      The proportion of patients that require hospital readmission for any cause within 30 days of hospital discharge

    3. Number of Participants Diagnosed With a National Surgical Quality Improvement Program (NSQIP) Defined Respiratory Complication [Length of hospitalization, an average of 1 week]

      pneumonia, unplanned re-intubation for any reason other than a return trip to the operating room, and ventilator times greater than 48 hours - excluding operating room time

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    70 Years and Older
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    Yes
    Inclusion Criteria:
    • Age ≥ 70 years

    • Elective surgery Monday through Friday in the South Operating Rooms of Oregon Health and Science University (OHSU)

    • Planned general endotracheal anesthesia

    • Expected surgical duration ≥ 3 hours

    Exclusion Criteria:
    • Prisoners

    • An inability to consent for surgery or anesthesia

    • Surgery for which neuromuscular blockade is contraindicated (e.g. neurosurgical, orthopedic, and head and neck surgery in which nerve monitoring will be employed)

    • A known neuromuscular disorder

    • Stage 4 chronic kidney disease or worse (estimated glomerular filtration rate < 30 ml/min)

    • Liver Disease

    • An allergies to Sugammadex, Rocuronium, Neostigmine, or Glycopyrrolate

    • Patients taking Toremifene

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Oregon Health and Science University Portland Oregon United States 97239

    Sponsors and Collaborators

    • Oregon Health and Science University
    • Merck Sharp & Dohme LLC

    Investigators

    • Principal Investigator: Brandon M Togioka, MD, Oregon Health and Science University

    Study Documents (Full-Text)

    More Information

    Publications

    None provided.
    Responsible Party:
    Brandon M Togioka, Assistant Professor, Oregon Health and Science University
    ClinicalTrials.gov Identifier:
    NCT02861131
    Other Study ID Numbers:
    • MISP #55196
    First Posted:
    Aug 10, 2016
    Last Update Posted:
    Mar 31, 2020
    Last Verified:
    Mar 1, 2020
    Individual Participant Data (IPD) Sharing Statement:
    No
    Plan to Share IPD:
    No
    Studies a U.S. FDA-regulated Drug Product:
    Yes
    Studies a U.S. FDA-regulated Device Product:
    No
    Product Manufactured in and Exported from the U.S.:
    No
    Keywords provided by Brandon M Togioka, Assistant Professor, Oregon Health and Science University
    Additional relevant MeSH terms:

    Study Results

    Participant Flow

    Recruitment Details
    Pre-assignment Detail
    Arm/Group Title Sugammadex Neostigmine
    Arm/Group Description Sugammadex 2 mg/kg IV once at the end of surgery Sugammadex: At the end of the surgical procedure at a depth of neuromuscular blockade after the reappearance of T2 on the train-of-four, Sugammadex will be dosed once at 2 mg/kg through an intravenous line with brisk flow Neostigmine 0.07 mg/kg to a maximum of 5 mg (+ Glycopyrrolate 0.1-0.2 mg per 1 mg of Neostigmine administered) IV once at the end of surgery Neostigmine: At the end of surgical procedure at a depth of neuromuscular blockade after the reappearance of T2 on the train-of-four, Neostigmine will be dosed once at 0.07 mg/kg to a maximum of 5 mg through an intravenous line with brisk flow. Glycopyrrolate will be administered with Neostigmine at a dose between 0.1 to 0.2 mg of Glycopyrrolate per 1.0 mg of Neostigmine administered.
    Period Title: Overall Study
    STARTED 100 100
    COMPLETED 100 100
    NOT COMPLETED 0 0

    Baseline Characteristics

    Arm/Group Title Sugammadex Neostigmine Total
    Arm/Group Description Sugammadex 2 mg/kg IV once at the end of surgery Sugammadex: At the end of the surgical procedure at a depth of neuromuscular blockade after the reappearance of T2 on the train-of-four, Sugammadex will be dosed once at 2 mg/kg through an intravenous line with brisk flow Neostigmine 0.07 mg/kg to a maximum of 5 mg (+ Glycopyrrolate 0.1-0.2 mg per 1 mg of Neostigmine administered) IV once at the end of surgery Neostigmine: At the end of surgical procedure at a depth of neuromuscular blockade after the reappearance of T2 on the train-of-four, Neostigmine will be dosed once at 0.07 mg/kg to a maximum of 5 mg through an intravenous line with brisk flow. Glycopyrrolate will be administered with Neostigmine at a dose between 0.1 to 0.2 mg of Glycopyrrolate per 1.0 mg of Neostigmine administered. Total of all reporting groups
    Overall Participants 100 100 200
    Age (years) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [years]
    74.8
    (4.3)
    75.1
    (4.0)
    74.9
    (4.1)
    Sex: Female, Male (Count of Participants)
    Female
    52
    52%
    56
    56%
    108
    54%
    Male
    48
    48%
    44
    44%
    92
    46%
    Race (NIH/OMB) (Count of Participants)
    American Indian or Alaska Native
    0
    0%
    0
    0%
    0
    0%
    Asian
    0
    0%
    0
    0%
    0
    0%
    Native Hawaiian or Other Pacific Islander
    0
    0%
    0
    0%
    0
    0%
    Black or African American
    0
    0%
    0
    0%
    0
    0%
    White
    97
    97%
    93
    93%
    190
    95%
    More than one race
    0
    0%
    0
    0%
    0
    0%
    Unknown or Not Reported
    3
    3%
    7
    7%
    10
    5%
    Region of Enrollment (participants) [Number]
    United States
    100
    100%
    100
    100%
    200
    100%

    Outcome Measures

    1. Primary Outcome
    Title Number of Participants With a Postoperative Pulmonary Complication
    Description A composite outcome which includes any of the following: postoperative pneumonia, aspiration pneumonitis, atelectasis, pneumothorax, desaturation/hypoxemia, upper airway obstruction, or acute respiratory insufficiency
    Time Frame Length of hospitalization, an average of 1 week

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Sugammadex Neostigmine
    Arm/Group Description Sugammadex 2 mg/kg IV once at the end of surgery Sugammadex: At the end of the surgical procedure at a depth of neuromuscular blockade after the reappearance of T2 on the train-of-four, Sugammadex will be dosed once at 2 mg/kg through an intravenous line with brisk flow Neostigmine 0.07 mg/kg to a maximum of 5 mg (+ Glycopyrrolate 0.1-0.2 mg per 1 mg of Neostigmine administered) IV once at the end of surgery Neostigmine: At the end of surgical procedure at a depth of neuromuscular blockade after the reappearance of T2 on the train-of-four, Neostigmine will be dosed once at 0.07 mg/kg to a maximum of 5 mg through an intravenous line with brisk flow. Glycopyrrolate will be administered with Neostigmine at a dose between 0.1 to 0.2 mg of Glycopyrrolate per 1.0 mg of Neostigmine administered.
    Measure Participants 100 100
    Count of Participants [Participants]
    33
    33%
    40
    40%
    2. Secondary Outcome
    Title Number of Participants With Residual Neuromuscular Blockade in the PACU
    Description Residual neuromuscular blockade will be defined as a train-of-four ratio < 0.9 taken within 5 minutes of subject arrival in the PACU
    Time Frame 1 day

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Sugammadex Neostigmine
    Arm/Group Description Sugammadex 2 mg/kg IV once at the end of surgery Sugammadex: At the end of the surgical procedure at a depth of neuromuscular blockade after the reappearance of T2 on the train-of-four, Sugammadex will be dosed once at 2 mg/kg through an intravenous line with brisk flow Neostigmine 0.07 mg/kg to a maximum of 5 mg (+ Glycopyrrolate 0.1-0.2 mg per 1 mg of Neostigmine administered) IV once at the end of surgery Neostigmine: At the end of surgical procedure at a depth of neuromuscular blockade after the reappearance of T2 on the train-of-four, Neostigmine will be dosed once at 0.07 mg/kg to a maximum of 5 mg through an intravenous line with brisk flow. Glycopyrrolate will be administered with Neostigmine at a dose between 0.1 to 0.2 mg of Glycopyrrolate per 1.0 mg of Neostigmine administered.
    Measure Participants 100 100
    Count of Participants [Participants]
    9
    9%
    46
    46%
    3. Secondary Outcome
    Title PACU Phase 1 Recovery Time
    Description Defined as duration of time required to attain pain control and stable respiratory, haemodynamic, and neurological status
    Time Frame 1 day

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Sugammadex Neostigmine
    Arm/Group Description Sugammadex 2 mg/kg IV once at the end of surgery Sugammadex: At the end of the surgical procedure at a depth of neuromuscular blockade after the reappearance of T2 on the train-of-four, Sugammadex will be dosed once at 2 mg/kg through an intravenous line with brisk flow Neostigmine 0.07 mg/kg to a maximum of 5 mg (+ Glycopyrrolate 0.1-0.2 mg per 1 mg of Neostigmine administered) IV once at the end of surgery Neostigmine: At the end of surgical procedure at a depth of neuromuscular blockade after the reappearance of T2 on the train-of-four, Neostigmine will be dosed once at 0.07 mg/kg to a maximum of 5 mg through an intravenous line with brisk flow. Glycopyrrolate will be administered with Neostigmine at a dose between 0.1 to 0.2 mg of Glycopyrrolate per 1.0 mg of Neostigmine administered.
    Measure Participants 100 100
    Mean (Standard Deviation) [minutes]
    97.3
    (54.3)
    110.0
    (62)
    4. Other Pre-specified Outcome
    Title Hospital Length of Stay
    Description Defined as the number of days between hospital admission and discharge
    Time Frame Length of hospitalization, an average of 1 week

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Sugammadex Neostigmine
    Arm/Group Description Sugammadex 2 mg/kg IV once at the end of surgery Sugammadex: At the end of the surgical procedure at a depth of neuromuscular blockade after the reappearance of T2 on the train-of-four, Sugammadex will be dosed once at 2 mg/kg through an intravenous line with brisk flow Neostigmine 0.07 mg/kg to a maximum of 5 mg (+ Glycopyrrolate 0.1-0.2 mg per 1 mg of Neostigmine administered) IV once at the end of surgery Neostigmine: At the end of surgical procedure at a depth of neuromuscular blockade after the reappearance of T2 on the train-of-four, Neostigmine will be dosed once at 0.07 mg/kg to a maximum of 5 mg through an intravenous line with brisk flow. Glycopyrrolate will be administered with Neostigmine at a dose between 0.1 to 0.2 mg of Glycopyrrolate per 1.0 mg of Neostigmine administered.
    Measure Participants 100 100
    Mean (Standard Deviation) [days]
    4.0
    (3.4)
    4.5
    (5.0)
    5. Other Pre-specified Outcome
    Title Number of Participants With Hospital Readmission Within 30 Days
    Description The proportion of patients that require hospital readmission for any cause within 30 days of hospital discharge
    Time Frame Length of hospitalization plus 30 days post-discharge

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Sugammadex Neostigmine
    Arm/Group Description Sugammadex 2 mg/kg IV once at the end of surgery Sugammadex: At the end of the surgical procedure at a depth of neuromuscular blockade after the reappearance of T2 on the train-of-four, Sugammadex will be dosed once at 2 mg/kg through an intravenous line with brisk flow Neostigmine 0.07 mg/kg to a maximum of 5 mg (+ Glycopyrrolate 0.1-0.2 mg per 1 mg of Neostigmine administered) IV once at the end of surgery Neostigmine: At the end of surgical procedure at a depth of neuromuscular blockade after the reappearance of T2 on the train-of-four, Neostigmine will be dosed once at 0.07 mg/kg to a maximum of 5 mg through an intravenous line with brisk flow. Glycopyrrolate will be administered with Neostigmine at a dose between 0.1 to 0.2 mg of Glycopyrrolate per 1.0 mg of Neostigmine administered.
    Measure Participants 100 100
    Count of Participants [Participants]
    5
    5%
    15
    15%
    6. Other Pre-specified Outcome
    Title Number of Participants Diagnosed With a National Surgical Quality Improvement Program (NSQIP) Defined Respiratory Complication
    Description pneumonia, unplanned re-intubation for any reason other than a return trip to the operating room, and ventilator times greater than 48 hours - excluding operating room time
    Time Frame Length of hospitalization, an average of 1 week

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Sugammadex Neostigmine
    Arm/Group Description Sugammadex 2 mg/kg IV once at the end of surgery Sugammadex: At the end of the surgical procedure at a depth of neuromuscular blockade after the reappearance of T2 on the train-of-four, Sugammadex will be dosed once at 2 mg/kg through an intravenous line with brisk flow Neostigmine 0.07 mg/kg to a maximum of 5 mg (+ Glycopyrrolate 0.1-0.2 mg per 1 mg of Neostigmine administered) IV once at the end of surgery Neostigmine: At the end of surgical procedure at a depth of neuromuscular blockade after the reappearance of T2 on the train-of-four, Neostigmine will be dosed once at 0.07 mg/kg to a maximum of 5 mg through an intravenous line with brisk flow. Glycopyrrolate will be administered with Neostigmine at a dose between 0.1 to 0.2 mg of Glycopyrrolate per 1.0 mg of Neostigmine administered.
    Measure Participants 100 100
    Count of Participants [Participants]
    4
    4%
    2
    2%

    Adverse Events

    Time Frame 30 days after discharge from the hospital
    Adverse Event Reporting Description
    Arm/Group Title Sugammadex Neostigmine
    Arm/Group Description Sugammadex 2 mg/kg IV once at the end of surgery Sugammadex: At the end of the surgical procedure at a depth of neuromuscular blockade after the reappearance of T2 on the train-of-four, Sugammadex will be dosed once at 2 mg/kg through an intravenous line with brisk flow Neostigmine 0.07 mg/kg to a maximum of 5 mg (+ Glycopyrrolate 0.1-0.2 mg per 1 mg of Neostigmine administered) IV once at the end of surgery Neostigmine: At the end of surgical procedure at a depth of neuromuscular blockade after the reappearance of T2 on the train-of-four, Neostigmine will be dosed once at 0.07 mg/kg to a maximum of 5 mg through an intravenous line with brisk flow. Glycopyrrolate will be administered with Neostigmine at a dose between 0.1 to 0.2 mg of Glycopyrrolate per 1.0 mg of Neostigmine administered.
    All Cause Mortality
    Sugammadex Neostigmine
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 2/100 (2%) 1/100 (1%)
    Serious Adverse Events
    Sugammadex Neostigmine
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 2/100 (2%) 3/100 (3%)
    Cardiac disorders
    Myocardial Infarction 0/100 (0%) 0 1/100 (1%) 1
    Infections and infestations
    Pneumonia leading to death 1/100 (1%) 1 0/100 (0%) 0
    Musculoskeletal and connective tissue disorders
    Significant Residual Neuromuscular Paralysis 0/100 (0%) 0 2/100 (2%) 2
    Nervous system disorders
    Cerebrovascular Accident 1/100 (1%) 1 0/100 (0%) 0
    Other (Not Including Serious) Adverse Events
    Sugammadex Neostigmine
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 50/100 (50%) 52/100 (52%)
    Gastrointestinal disorders
    Nausea or Vomiting 14/100 (14%) 14 17/100 (17%) 17
    Foul, salty or metallic taste 19/100 (19%) 19 13/100 (13%) 13
    Nervous system disorders
    Headache 7/100 (7%) 7 7/100 (7%) 7
    Respiratory, thoracic and mediastinal disorders
    Bronchospasm 1/100 (1%) 1 2/100 (2%) 2
    Cough 4/100 (4%) 4 5/100 (5%) 5
    Skin and subcutaneous tissue disorders
    Itching 5/100 (5%) 5 8/100 (8%) 8

    Limitations/Caveats

    [Not Specified]

    More Information

    Certain Agreements

    Principal Investigators are NOT employed by the organization sponsoring the study.

    There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.

    Results Point of Contact

    Name/Title Brandon Togioka
    Organization Oregon Health & Science University
    Phone 5034944572
    Email togioka@ohsu.edu
    Responsible Party:
    Brandon M Togioka, Assistant Professor, Oregon Health and Science University
    ClinicalTrials.gov Identifier:
    NCT02861131
    Other Study ID Numbers:
    • MISP #55196
    First Posted:
    Aug 10, 2016
    Last Update Posted:
    Mar 31, 2020
    Last Verified:
    Mar 1, 2020