Clinical Trial Results:
Randomized, Controlled, Parallel-Group, Double-Blind Trial to Compare the Use of Deep or Standard Neuromuscular Blockade in Combination With Low or Standard Insufflation Pressures Using a 2x2 Factorial Design in Patients Undergoing Laparoscopic Cholecystectomy (Protocol No. MK-8616-076-03 also known as SCH 900616, P07982)
Summary
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EudraCT number |
2012-001886-33 |
Trial protocol |
DE AT FI GB IT |
Global end of trial date |
29 Apr 2014
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Results information
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Results version number |
v2(current) |
This version publication date |
06 May 2016
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First version publication date |
02 May 2015
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Other versions |
v1 |
Version creation reason |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
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Trial identification
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Sponsor protocol code |
P07982
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
NCT01728584 | ||
WHO universal trial number (UTN) |
- | ||
Other trial identifiers |
Merck Registration number: P07982 | ||
Sponsors
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Sponsor organisation name |
Merck Sharp & Dohme Corp.
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Sponsor organisation address |
2000 Galloping Hill Road, Kenilworth, NJ, United States, 07033
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Public contact |
Clinical Trials Disclosure, Merck Sharp & Dohme Corp., ClinicalTrialsDisclosure@merck.com
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Scientific contact |
Clinical Trials Disclosure, Merck Sharp & Dohme Corp., ClinicalTrialsDisclosure@merck.com
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Paediatric regulatory details
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Is trial part of an agreed paediatric investigation plan (PIP) |
No
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Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Results analysis stage
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Analysis stage |
Final
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Date of interim/final analysis |
29 Apr 2014
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Is this the analysis of the primary completion data? |
Yes
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Primary completion date |
29 Apr 2014
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Global end of trial reached? |
Yes
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Global end of trial date |
29 Apr 2014
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Was the trial ended prematurely? |
No
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General information about the trial
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Main objective of the trial |
Purpose of study is to compare use of deep or standard neuromuscular blockade (NMB) in combination with low or standard insufflation pressure in participants undergoing laparoscopic cholecystectomy. Primary hypothesis is that use of sustained deep NMB improves the surgeon's overall satisfaction with surgical conditions versus standard NMB. Inpatient surgery is performed on Day 1, and participant remains hospitalized for at least 24-48 hours after surgery, with follow-up visit/contact on Day 8. During procedure, surgeon could request modification to randomized treatment conditions (“rescue intervention”), if surgeon considered surgical conditions unacceptable. For participant on standard NMB, preferred rescue intervention was increase of NMB from standard to deep level; second option, if available, was to raise insufflation pressure from low to standard. If the participant was already on deep NMB, preferred option, if available, was to raise insufflation pressure from low to standard.
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Protection of trial subjects |
This study was conducted in conformance with Good Clinical Practice standards and applicable country and/or local statutes and regulations regarding ethical committee review, informed consent, and the protection of human subjects participating in biomedical research.
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Background therapy |
- | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
28 Nov 2012
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Long term follow-up planned |
No
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Independent data monitoring committee (IDMC) involvement? |
No
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Population of trial subjects
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Number of subjects enrolled per country |
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Country: Number of subjects enrolled |
Austria: 43
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Country: Number of subjects enrolled |
Finland: 11
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Country: Number of subjects enrolled |
Germany: 40
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Country: Number of subjects enrolled |
Italy: 20
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Country: Number of subjects enrolled |
United Kingdom: 13
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Worldwide total number of subjects |
127
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EEA total number of subjects |
127
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Number of subjects enrolled per age group |
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In utero |
0
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Preterm newborn - gestational age < 37 wk |
0
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Newborns (0-27 days) |
0
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Infants and toddlers (28 days-23 months) |
0
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Children (2-11 years) |
0
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Adolescents (12-17 years) |
0
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Adults (18-64 years) |
112
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From 65 to 84 years |
15
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85 years and over |
0
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Recruitment
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Recruitment details |
- | |||||||||||||||||||||||||||||||||||||||||||||
Pre-assignment
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Screening details |
Participants were randomized to 4 arms based on combinations of NMB depth and insufflation pressure level. During procedure, blinded surgeon could request that unblinded anesthetist change the randomized treatment conditions (“rescue intervention”), if surgeon considered surgical conditions to be unacceptable. | |||||||||||||||||||||||||||||||||||||||||||||
Period 1
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Period 1 title |
Overall Study (overall period)
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Is this the baseline period? |
Yes | |||||||||||||||||||||||||||||||||||||||||||||
Allocation method |
Randomised - controlled
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Blinding used |
Double blind [1] | |||||||||||||||||||||||||||||||||||||||||||||
Roles blinded |
Assessor, Subject | |||||||||||||||||||||||||||||||||||||||||||||
Blinding implementation details |
The surgeon was blinded to random assignment. The anesthetist controlling the surgical conditions (depth of NMB, insufflation pressure level) was unblinded.
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Arms
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Are arms mutually exclusive |
Yes
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Arm title
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Standard NMB and Standard Insufflation Pressure | |||||||||||||||||||||||||||||||||||||||||||||
Arm description |
Treatment condition for this reporting group is Standard NMB (depth of blockade at a targeted Train of Four [TOF] ratio of 10%)/Standard insufflation pressure (starting pressure of 12 mmHg). | |||||||||||||||||||||||||||||||||||||||||||||
Arm type |
Experimental | |||||||||||||||||||||||||||||||||||||||||||||
Investigational medicinal product name |
Rocuronium
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Investigational medicinal product code |
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Other name |
Esmeron® Injection (rocuronium bromide), Zemuron® Injection (rocuronium bromide)
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Pharmaceutical forms |
Solution for injection
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Routes of administration |
Intravenous use
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Dosage and administration details |
NMB will be induced by intravenous (IV) administration of a bolus dose of 0.45 mg/kg rocuronium. NMB will be maintained using rocuronium infusion or additional bolus doses as needed for the management of NMB to the targeted depth according to the assigned treatment condition: Standard NMB - administration of neuromuscular blocking agent (NMBA) titrated to a depth of blockade at a targeted TOF ratio of 10% (range: TOF count 2-3 to TOF ratio of 20%); Deep NMB - administration of NMBA titrated to a targeted depth of 1-2 Post Tetanic Counts (PTCs) (range: 1-5 PTC).
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Investigational medicinal product name |
Carbon dioxide gas
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Medicinal gas, compressed
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Routes of administration |
Intraperitoneal use
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Dosage and administration details |
Insufflation (injection) of carbon dioxide will be used to induce pneumoperitoneum, which is presence of air or gas in the abdominal (peritoneal) cavity: Standard insufflation pressure - a starting pressure of 12 mmHg will be used; Low insufflation pressure - a starting pressure of 8 mmHg will be used.
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Investigational medicinal product name |
Sugammadex
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Investigational medicinal product code |
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Other name |
sugammadex sodium injection, SCH 900616, Org 25969, Bridion®
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Pharmaceutical forms |
Solution for injection
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Routes of administration |
Intravenous use
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Dosage and administration details |
NMB will be reversed with IV administration of 2 or 4 mg/kg sugammadex (depending on the depth of NMB) according to the approved label for sugammadex.
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Arm title
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Standard NMB and Low Insufflation Pressure | |||||||||||||||||||||||||||||||||||||||||||||
Arm description |
Treatment condition for this reporting group is Standard NMB (depth of blockade at a targeted TOF ratio of 10%)/Low insufflation pressure (starting pressure of 8 mmHg). | |||||||||||||||||||||||||||||||||||||||||||||
Arm type |
Experimental | |||||||||||||||||||||||||||||||||||||||||||||
Investigational medicinal product name |
Rocuronium
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Investigational medicinal product code |
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Other name |
Esmeron® Injection (rocuronium bromide), Zemuron® Injection (rocuronium bromide)
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Pharmaceutical forms |
Solution for injection
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Routes of administration |
Intravenous use
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Dosage and administration details |
NMB will be induced by IV administration of a bolus dose of 0.45 mg/kg rocuronium. NMB will be maintained using rocuronium infusion or additional bolus doses as needed for the management of NMB to the targeted depth according to the assigned treatment condition: Standard NMB - administration of NMBA titrated to a depth of blockade at a targeted TOF ratio of 10% (range: TOF count 2-3 to TOF ratio of 20%); Deep NMB - administration of NMBA titrated to a targeted depth of 1-2 PTCs (range: 1-5 PTC).
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Investigational medicinal product name |
Sugammadex
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Investigational medicinal product code |
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Other name |
sugammadex sodium injection, SCH 900616, Org 25969, Bridion®
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Pharmaceutical forms |
Solution for injection
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Routes of administration |
Intravenous use
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Dosage and administration details |
NMB will be reversed with IV administration of 2 or 4 mg/kg sugammadex (depending on the depth of NMB) according to the approved label for sugammadex.
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Investigational medicinal product name |
Carbon dioxide gas
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Medicinal gas, compressed
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Routes of administration |
Intraperitoneal use
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Dosage and administration details |
Insufflation (injection) of carbon dioxide will be used to induce pneumoperitoneum, which is presence of air or gas in the abdominal (peritoneal) cavity: Standard insufflation pressure - a starting pressure of 12 mmHg will be used; Low insufflation pressure - a starting pressure of 8 mmHg will be used.
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Arm title
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Deep NMB and Standard Insufflation Pressure | |||||||||||||||||||||||||||||||||||||||||||||
Arm description |
Treatment condition for this reporting group is Deep NMB (depth of blockade of 1-2 PTCs)/Standard insufflation pressure (starting pressure of 12 mmHg). | |||||||||||||||||||||||||||||||||||||||||||||
Arm type |
Experimental | |||||||||||||||||||||||||||||||||||||||||||||
Investigational medicinal product name |
Rocuronium
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Investigational medicinal product code |
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Other name |
Esmeron® Injection (rocuronium bromide), Zemuron® Injection (rocuronium bromide)
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Pharmaceutical forms |
Solution for injection
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Routes of administration |
Intravenous use
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Dosage and administration details |
NMB will be induced by IV administration of a bolus dose of 0.45 mg/kg rocuronium. NMB will be maintained using rocuronium infusion or additional bolus doses as needed for the management of NMB to the targeted depth according to the assigned treatment condition: Standard NMB - administration of NMBA titrated to a depth of blockade at a targeted TOF ratio of 10% (range: TOF count 2-3 to TOF ratio of 20%); Deep NMB - administration of NMBA titrated to a targeted depth of 1-2 PTCs (range: 1-5 PTC).
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Investigational medicinal product name |
Sugammadex
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Investigational medicinal product code |
||||||||||||||||||||||||||||||||||||||||||||||
Other name |
sugammadex sodium injection, SCH 900616, Org 25969, Bridion®
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Pharmaceutical forms |
Solution for injection
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Routes of administration |
Intravenous use
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Dosage and administration details |
NMB will be reversed with IV administration of 2 or 4 mg/kg sugammadex (depending on the depth of NMB) according to the approved label for sugammadex.
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Investigational medicinal product name |
Carbon dioxide gas
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Medicinal gas, compressed
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Routes of administration |
Intraperitoneal use
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Dosage and administration details |
Insufflation (injection) of carbon dioxide will be used to induce pneumoperitoneum, which is presence of air or gas in the abdominal (peritoneal) cavity: Standard insufflation pressure - a starting pressure of 12 mmHg will be used; Low insufflation pressure - a starting pressure of 8 mmHg will be used.
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Arm title
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Deep NMB and Low Insufflation Pressure | |||||||||||||||||||||||||||||||||||||||||||||
Arm description |
Treatment condition for this reporting group is Deep NMB (depth of blockade of 1-2 PTCs)/Low insufflation pressure (starting pressure of 8 mmHg). | |||||||||||||||||||||||||||||||||||||||||||||
Arm type |
Experimental | |||||||||||||||||||||||||||||||||||||||||||||
Investigational medicinal product name |
Rocuronium
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Investigational medicinal product code |
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Other name |
Esmeron® Injection (rocuronium bromide), Zemuron® Injection (rocuronium bromide)
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Pharmaceutical forms |
Solution for injection
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Routes of administration |
Intravenous use
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Dosage and administration details |
NMB will be induced by IV administration of a bolus dose of 0.45 mg/kg rocuronium. NMB will be maintained using rocuronium infusion or additional bolus doses as needed for the management of NMB to the targeted depth according to the assigned treatment condition: Standard NMB - administration of NMBA titrated to a depth of blockade at a targeted TOF ratio of 10% (range: TOF count 2-3 to TOF ratio of 20%); Deep NMB - administration of NMBA titrated to a targeted depth of 1-2 PTCs (range: 1-5 PTC).
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Investigational medicinal product name |
Carbon dioxide gas
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Medicinal gas, compressed
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Routes of administration |
Intraperitoneal use
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Dosage and administration details |
Insufflation (injection) of carbon dioxide will be used to induce pneumoperitoneum, which is presence of air or gas in the abdominal (peritoneal) cavity: Standard insufflation pressure - a starting pressure of 12 mmHg will be used; Low insufflation pressure - a starting pressure of 8 mmHg will be used.
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Investigational medicinal product name |
Sugammadex
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Investigational medicinal product code |
||||||||||||||||||||||||||||||||||||||||||||||
Other name |
sugammadex sodium injection, SCH 900616, Org 25969, Bridion®
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Pharmaceutical forms |
Solution for injection
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Routes of administration |
Intravenous use
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Dosage and administration details |
NMB will be reversed with IV administration of 2 or 4 mg/kg sugammadex (depending on the depth of NMB) according to the approved label for sugammadex.
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Notes [1] - The roles blinded appear to be inconsistent with a double blind trial. Justification: The surgeon, who made ratings of surgical conditions used for primary outcome measures and several other efficacy endpoints, was blinded to random assignment. The anesthetist controlling the surgical conditions was unblinded. A blinded safety assessor evaluated safety parameters, pain scores and analgesic medication use. Appropriate Sponsor personnel were blinded to random assignment. |
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Baseline characteristics reporting groups
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Reporting group title |
Standard NMB and Standard Insufflation Pressure
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Reporting group description |
Treatment condition for this reporting group is Standard NMB (depth of blockade at a targeted Train of Four [TOF] ratio of 10%)/Standard insufflation pressure (starting pressure of 12 mmHg). | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Standard NMB and Low Insufflation Pressure
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Reporting group description |
Treatment condition for this reporting group is Standard NMB (depth of blockade at a targeted TOF ratio of 10%)/Low insufflation pressure (starting pressure of 8 mmHg). | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Deep NMB and Standard Insufflation Pressure
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Reporting group description |
Treatment condition for this reporting group is Deep NMB (depth of blockade of 1-2 PTCs)/Standard insufflation pressure (starting pressure of 12 mmHg). | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Deep NMB and Low Insufflation Pressure
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Reporting group description |
Treatment condition for this reporting group is Deep NMB (depth of blockade of 1-2 PTCs)/Low insufflation pressure (starting pressure of 8 mmHg). | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
Standard NMB and Standard Insufflation Pressure
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Reporting group description |
Treatment condition for this reporting group is Standard NMB (depth of blockade at a targeted Train of Four [TOF] ratio of 10%)/Standard insufflation pressure (starting pressure of 12 mmHg). | ||
Reporting group title |
Standard NMB and Low Insufflation Pressure
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Reporting group description |
Treatment condition for this reporting group is Standard NMB (depth of blockade at a targeted TOF ratio of 10%)/Low insufflation pressure (starting pressure of 8 mmHg). | ||
Reporting group title |
Deep NMB and Standard Insufflation Pressure
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Reporting group description |
Treatment condition for this reporting group is Deep NMB (depth of blockade of 1-2 PTCs)/Standard insufflation pressure (starting pressure of 12 mmHg). | ||
Reporting group title |
Deep NMB and Low Insufflation Pressure
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Reporting group description |
Treatment condition for this reporting group is Deep NMB (depth of blockade of 1-2 PTCs)/Low insufflation pressure (starting pressure of 8 mmHg). | ||
Subject analysis set title |
Standard NMB
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Subject analysis set type |
Full analysis | ||
Subject analysis set description |
Treatment condition for this reporting group is Standard NMB (depth of blockade at a targeted TOF ratio of 10%), whether in combination with Standard or Low insufflation pressure. Therefore, the included arms are Standard NMB/Standard insufflation pressure and Standard NMB/Low insufflation pressure.
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Subject analysis set title |
Deep NMB
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Subject analysis set type |
Full analysis | ||
Subject analysis set description |
Treatment condition for this reporting group is Deep NMB (depth of blockade of 1-2 PTCs), whether in combination with Standard or Low insufflation pressure. Therefore, the included arms are Deep NMB/Standard insufflation pressure and Deep NMB/Low insufflation pressure.
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Subject analysis set title |
Standard Insufflation Pressure
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Subject analysis set type |
Full analysis | ||
Subject analysis set description |
Treatment condition for this reporting group is Standard insufflation pressure (starting pressure of 12 mmHg), whether in combination with Standard or Deep NMB. Therefore, the included arms are Standard NMB/Standard insufflation pressure and Deep NMB/Standard insufflation pressure.
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Subject analysis set title |
Low Insufflation Pressure
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Subject analysis set type |
Full analysis | ||
Subject analysis set description |
Treatment condition for this reporting group is Low insufflation pressure (starting pressure of 8 mmHg), whether in combination with Standard or Deep NMB. Therefore, the included arms are Standard NMB/Low insufflation pressure and Deep NMB/Low insufflation pressure.
|
||
Subject analysis set title |
Standard NMB and Standard Insufflation Pressure
|
||
Subject analysis set type |
Full analysis | ||
Subject analysis set description |
Treatment condition for this reporting group is Standard NMB (depth of blockade at a targeted TOF ratio of 10%)/Standard insufflation pressure (starting pressure of 12 mmHg). Participants were included in arm corresponding to treatment actually received, which in case of rescue intervention was the post-intervention condition.
|
||
Subject analysis set title |
Standard NMB and Low Insufflation Pressure
|
||
Subject analysis set type |
Full analysis | ||
Subject analysis set description |
Treatment condition for this reporting group is Standard NMB (depth of blockade at a targeted TOF ratio of 10%)/Low insufflation pressure (starting pressure of 8 mmHg). Participants were included in arm corresponding to treatment actually received, which in case of rescue intervention was the post-intervention condition.
|
||
Subject analysis set title |
Deep NMB and Standard Insufflation Pressure
|
||
Subject analysis set type |
Full analysis | ||
Subject analysis set description |
Treatment condition for this reporting group is Deep NMB (depth of blockade of 1-2 PTCs)/Standard insufflation pressure (starting pressure of 12 mmHg). Participants were included in arm corresponding to treatment actually received, which in case of rescue intervention was the post-intervention condition.
|
||
Subject analysis set title |
Deep NMB and Low Insufflation Pressure
|
||
Subject analysis set type |
Full analysis | ||
Subject analysis set description |
Treatment condition for this reporting group is Deep NMB (depth of blockade of 1-2 PTCs)/Low insufflation pressure (starting pressure of 8 mmHg). Participants were included in arm corresponding to treatment actually received, which in case of rescue intervention was the post-intervention condition.
|
|
|||||||||||||||||||||
End point title |
Score on surgeon's assessment of overall satisfaction with the surgical conditions: By depth of NMB (standard, deep) and insufflation pressure (standard, low) | ||||||||||||||||||||
End point description |
At the end of the procedure the surgeon responds to the following question, using an 11-point scale from 0 (poor, needed intervention) to 10 (excellent): "How satisfied were you overall with the surgical conditions related to anesthesia and pneumoperitoneum during the surgery you just performed?" If at any time the surgeon requests a rescue intervention, the overall assessment of surgical conditions should be rated as 0 (=poor, needed intervention). The surgeon will rate the surgical conditions according to his opinion but if a rescue intervention has been applied, that individual participant will be counted with a score of zero in the analysis. Population for analysis was randomized participants with available data who had NMB and pneumoperitoneum for laparoscopic surgery, and did not convert to open surgery before NMB and/or pressure application. Participants were included in the treatment arm to which they were randomized.
|
||||||||||||||||||||
End point type |
Primary
|
||||||||||||||||||||
End point timeframe |
End of surgery (Day 1)
|
||||||||||||||||||||
|
|||||||||||||||||||||
Statistical analysis title |
Comparison by NMB (standard, deep) | ||||||||||||||||||||
Statistical analysis description |
Primary hypothesis – deep NMB improves surgeon’s overall satisfaction with the surgical conditions compared to standard NMB. Analysis of covariance (ANCOVA) model included factors depth of NMB, level of pressure, surgeon and body mass index (BMI).
|
||||||||||||||||||||
Comparison groups |
Standard NMB v Deep NMB
|
||||||||||||||||||||
Number of subjects included in analysis |
120
|
||||||||||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||||||||||
Analysis type |
superiority | ||||||||||||||||||||
P-value |
= 0.026 | ||||||||||||||||||||
Method |
ANCOVA | ||||||||||||||||||||
Parameter type |
Difference in Least Squares (LS) Means | ||||||||||||||||||||
Point estimate |
1.09
|
||||||||||||||||||||
Confidence interval |
|||||||||||||||||||||
level |
95% | ||||||||||||||||||||
sides |
2-sided
|
||||||||||||||||||||
lower limit |
0.13 | ||||||||||||||||||||
upper limit |
2.04 | ||||||||||||||||||||
Statistical analysis title |
Comparison by pressure (standard, low) | ||||||||||||||||||||
Statistical analysis description |
ANCOVA model included factors depth of NMB, level of pressure, surgeon and BMI.
|
||||||||||||||||||||
Comparison groups |
Low Insufflation Pressure v Standard Insufflation Pressure
|
||||||||||||||||||||
Number of subjects included in analysis |
120
|
||||||||||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||||||||||
Analysis type |
other | ||||||||||||||||||||
P-value |
< 0.001 | ||||||||||||||||||||
Method |
ANCOVA | ||||||||||||||||||||
Parameter type |
Difference in LS Means | ||||||||||||||||||||
Point estimate |
-3.02
|
||||||||||||||||||||
Confidence interval |
|||||||||||||||||||||
level |
95% | ||||||||||||||||||||
sides |
2-sided
|
||||||||||||||||||||
lower limit |
-3.99 | ||||||||||||||||||||
upper limit |
-2.05 |
|
|||||||||||||||||||||
End point title |
Score on surgeon's assessment of overall satisfaction with the surgical conditions: By treatment arm | ||||||||||||||||||||
End point description |
At the end of the procedure the surgeon responds to the following question, using an 11-point scale from 0 (poor, needed intervention) to 10 (excellent): "How satisfied were you overall with the surgical conditions related to anesthesia and pneumoperitoneum during the surgery you just performed?" If at any time the surgeon requests a rescue intervention, the overall assessment of surgical conditions should be rated as 0 (=poor, needed intervention). The surgeon will rate the surgical conditions according to his opinion but if a rescue intervention has been applied, that individual participant will be counted with a score of zero in the analysis. Population for analysis was randomized participants with available data who had NMB and pneumoperitoneum for laparoscopic surgery, and did not convert to open surgery before NMB and/or pressure application. Participants were included in the treatment arm to which they were randomized.
|
||||||||||||||||||||
End point type |
Primary
|
||||||||||||||||||||
End point timeframe |
End of surgery (Day 1)
|
||||||||||||||||||||
|
|||||||||||||||||||||
Statistical analysis title |
Comparison by treatment arm | ||||||||||||||||||||
Statistical analysis description |
ANCOVA model included factors depth of NMB, level of pressure, surgeon and BMI.
|
||||||||||||||||||||
Comparison groups |
Standard NMB and Standard Insufflation Pressure v Standard NMB and Low Insufflation Pressure
|
||||||||||||||||||||
Number of subjects included in analysis |
60
|
||||||||||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||||||||||
Analysis type |
other | ||||||||||||||||||||
Method |
|||||||||||||||||||||
Parameter type |
Difference in Least Squares (LS) Means | ||||||||||||||||||||
Point estimate |
3.66
|
||||||||||||||||||||
Confidence interval |
|||||||||||||||||||||
level |
95% | ||||||||||||||||||||
sides |
2-sided
|
||||||||||||||||||||
lower limit |
2.3 | ||||||||||||||||||||
upper limit |
5.02 | ||||||||||||||||||||
Statistical analysis title |
Comparison by treatment arm | ||||||||||||||||||||
Statistical analysis description |
ANCOVA model included factors depth of NMB, level of pressure, surgeon and BMI.
|
||||||||||||||||||||
Comparison groups |
Standard NMB and Standard Insufflation Pressure v Deep NMB and Standard Insufflation Pressure
|
||||||||||||||||||||
Number of subjects included in analysis |
60
|
||||||||||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||||||||||
Analysis type |
other | ||||||||||||||||||||
Method |
|||||||||||||||||||||
Parameter type |
Difference in LS Means | ||||||||||||||||||||
Point estimate |
-0.44
|
||||||||||||||||||||
Confidence interval |
|||||||||||||||||||||
level |
95% | ||||||||||||||||||||
sides |
2-sided
|
||||||||||||||||||||
lower limit |
-1.8 | ||||||||||||||||||||
upper limit |
0.91 | ||||||||||||||||||||
Statistical analysis title |
Comparison by treatment arm | ||||||||||||||||||||
Statistical analysis description |
ANCOVA model included factors depth of NMB, level of pressure, surgeon and BMI.
|
||||||||||||||||||||
Comparison groups |
Standard NMB and Standard Insufflation Pressure v Deep NMB and Low Insufflation Pressure
|
||||||||||||||||||||
Number of subjects included in analysis |
60
|
||||||||||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||||||||||
Analysis type |
other | ||||||||||||||||||||
Method |
|||||||||||||||||||||
Parameter type |
Difference in LS Means | ||||||||||||||||||||
Point estimate |
1.96
|
||||||||||||||||||||
Confidence interval |
|||||||||||||||||||||
level |
95% | ||||||||||||||||||||
sides |
2-sided
|
||||||||||||||||||||
lower limit |
0.57 | ||||||||||||||||||||
upper limit |
3.36 | ||||||||||||||||||||
Statistical analysis title |
Comparison by treatment arm | ||||||||||||||||||||
Statistical analysis description |
ANCOVA model included factors depth of NMB, level of pressure, surgeon and BMI.
|
||||||||||||||||||||
Comparison groups |
Standard NMB and Low Insufflation Pressure v Deep NMB and Standard Insufflation Pressure
|
||||||||||||||||||||
Number of subjects included in analysis |
60
|
||||||||||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||||||||||
Analysis type |
other | ||||||||||||||||||||
Method |
|||||||||||||||||||||
Parameter type |
Difference in LS Means | ||||||||||||||||||||
Point estimate |
-4.1
|
||||||||||||||||||||
Confidence interval |
|||||||||||||||||||||
level |
95% | ||||||||||||||||||||
sides |
2-sided
|
||||||||||||||||||||
lower limit |
-5.42 | ||||||||||||||||||||
upper limit |
-2.78 | ||||||||||||||||||||
Statistical analysis title |
Comparison by treatment arm | ||||||||||||||||||||
Statistical analysis description |
ANCOVA model included factors depth of NMB, level of pressure, surgeon and BMI.
|
||||||||||||||||||||
Comparison groups |
Standard NMB and Low Insufflation Pressure v Deep NMB and Low Insufflation Pressure
|
||||||||||||||||||||
Number of subjects included in analysis |
60
|
||||||||||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||||||||||
Analysis type |
other | ||||||||||||||||||||
Method |
|||||||||||||||||||||
Parameter type |
Difference in LS Means | ||||||||||||||||||||
Point estimate |
-1.7
|
||||||||||||||||||||
Confidence interval |
|||||||||||||||||||||
level |
95% | ||||||||||||||||||||
sides |
2-sided
|
||||||||||||||||||||
lower limit |
-3.01 | ||||||||||||||||||||
upper limit |
-0.38 | ||||||||||||||||||||
Statistical analysis title |
Comparison by treatment arm | ||||||||||||||||||||
Statistical analysis description |
ANCOVA model included factors depth of NMB, level of pressure, surgeon and BMI.
|
||||||||||||||||||||
Comparison groups |
Deep NMB and Standard Insufflation Pressure v Deep NMB and Low Insufflation Pressure
|
||||||||||||||||||||
Number of subjects included in analysis |
60
|
||||||||||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||||||||||
Analysis type |
other | ||||||||||||||||||||
Method |
|||||||||||||||||||||
Parameter type |
Difference in LS Means | ||||||||||||||||||||
Point estimate |
2.41
|
||||||||||||||||||||
Confidence interval |
|||||||||||||||||||||
level |
95% | ||||||||||||||||||||
sides |
2-sided
|
||||||||||||||||||||
lower limit |
1.08 | ||||||||||||||||||||
upper limit |
3.74 |
|
|||||||||||||||||||||
End point title |
Participant's overall average pain score in the first 24 hours after administration of sugammadex: By depth of NMB (standard, deep) and insufflation pressure (standard, low) | ||||||||||||||||||||
End point description |
Participants rated pain at 1, 2, 4, 24 and 48 hours after the administration of sugammadex on day of surgery (Day 1), and daily from Day 3 to Day 8. Pain rating was made using an 11-point scale from 0 (no pain) to 10 (severe pain). Separate ratings were made for overall pain at rest, pain when provoked (e.g., due to participant transition from lying to sitting position) and shoulder pain at rest. The participant’s overall average pain score within 24 hours after sugammadex was the average of all pain assessments (including all 3 pain types assessed) at 1, 2, 4 and 24 hours after sugammadex dose. Population for analysis was randomized participants with available data who had NMB or pneumoperitoneum for laparoscopic surgery, or received sugammadex, and did not convert to open surgery before NMB and/or pressure. Participants were included in arm corresponding to treatment actually received, which in case of rescue intervention was the post-intervention condition.
|
||||||||||||||||||||
End point type |
Secondary
|
||||||||||||||||||||
End point timeframe |
Up to 24 hours after administration of sugammadex on Day 1
|
||||||||||||||||||||
|
|||||||||||||||||||||
Statistical analysis title |
Comparison by NMB (standard, deep) | ||||||||||||||||||||
Statistical analysis description |
Analysis of variance (ANOVA) model included factors depth of NMB, level of pressure, gender and surgeon.
|
||||||||||||||||||||
Comparison groups |
Deep NMB v Standard NMB
|
||||||||||||||||||||
Number of subjects included in analysis |
120
|
||||||||||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||||||||||
Analysis type |
other | ||||||||||||||||||||
P-value |
= 0.148 | ||||||||||||||||||||
Method |
ANOVA | ||||||||||||||||||||
Parameter type |
Difference in LS Means | ||||||||||||||||||||
Point estimate |
0.35
|
||||||||||||||||||||
Confidence interval |
|||||||||||||||||||||
level |
95% | ||||||||||||||||||||
sides |
2-sided
|
||||||||||||||||||||
lower limit |
-0.13 | ||||||||||||||||||||
upper limit |
0.84 | ||||||||||||||||||||
Statistical analysis title |
Comparison by pressure (standard, low) | ||||||||||||||||||||
Statistical analysis description |
Key secondary hypothesis – low insufflation pressure improves overall average pain score in first 24 hours compared to standard insufflation pressure. ANOVA model included factors depth of NMB, level of pressure, gender and surgeon.
|
||||||||||||||||||||
Comparison groups |
Low Insufflation Pressure v Standard Insufflation Pressure
|
||||||||||||||||||||
Number of subjects included in analysis |
120
|
||||||||||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||||||||||
Analysis type |
superiority | ||||||||||||||||||||
P-value |
= 0.494 [1] | ||||||||||||||||||||
Method |
ANOVA | ||||||||||||||||||||
Parameter type |
Difference in LS Means | ||||||||||||||||||||
Point estimate |
-0.17
|
||||||||||||||||||||
Confidence interval |
|||||||||||||||||||||
level |
95% | ||||||||||||||||||||
sides |
2-sided
|
||||||||||||||||||||
lower limit |
-0.67 | ||||||||||||||||||||
upper limit |
0.33 | ||||||||||||||||||||
Notes [1] - To control for multiple testing, this difference was formally tested only if comparison of surgeon’s overall satisfaction with surgical conditions for deep versus standard NMB was significant at the 5% level, with greater satisfaction for deep NMB. |
|
|||||||||||||||||||||
End point title |
Participant's overall average pain score in the first 24 hours after administration of sugammadex: By treatment arm | ||||||||||||||||||||
End point description |
Participants rated pain at 1, 2, 4, 24 and 48 hours after the administration of sugammadex on day of surgery (Day 1), and daily from Day 3 to Day 8. Pain rating was made using an 11-point scale from 0 (no pain) to 10 (severe pain). Separate ratings were made for overall pain at rest, pain when provoked (e.g., due to participant transition from lying to sitting position) and shoulder pain at rest. The participant’s overall average pain score within 24 hours after sugammadex was the average of all pain assessments (including all 3 pain types assessed) at 1, 2, 4 and 24 hours after sugammadex dose. Population for analysis was randomized participants with available data who had NMB or pneumoperitoneum for laparoscopic surgery, or received sugammadex, and did not convert to open surgery before NMB and/or pressure. Participants were included in arm corresponding to treatment actually received, which in case of rescue intervention was the post-intervention condition.
|
||||||||||||||||||||
End point type |
Secondary
|
||||||||||||||||||||
End point timeframe |
Up to 24 hours after administration of sugammadex on Day 1
|
||||||||||||||||||||
|
|||||||||||||||||||||
Statistical analysis title |
Comparison by treatment arm | ||||||||||||||||||||
Statistical analysis description |
ANOVA model included factors treatment group, gender and surgeon.
|
||||||||||||||||||||
Comparison groups |
Standard NMB and Standard Insufflation Pressure v Standard NMB and Low Insufflation Pressure
|
||||||||||||||||||||
Number of subjects included in analysis |
55
|
||||||||||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||||||||||
Analysis type |
other | ||||||||||||||||||||
Method |
|||||||||||||||||||||
Parameter type |
Difference in LS Means | ||||||||||||||||||||
Point estimate |
-0.2
|
||||||||||||||||||||
Confidence interval |
|||||||||||||||||||||
level |
95% | ||||||||||||||||||||
sides |
2-sided
|
||||||||||||||||||||
lower limit |
-0.92 | ||||||||||||||||||||
upper limit |
0.52 | ||||||||||||||||||||
Statistical analysis title |
Comparison by treatment arm | ||||||||||||||||||||
Statistical analysis description |
ANOVA model included factors treatment group, gender and surgeon.
|
||||||||||||||||||||
Comparison groups |
Standard NMB and Standard Insufflation Pressure v Deep NMB and Standard Insufflation Pressure
|
||||||||||||||||||||
Number of subjects included in analysis |
71
|
||||||||||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||||||||||
Analysis type |
other | ||||||||||||||||||||
Method |
|||||||||||||||||||||
Parameter type |
Difference in LS Means | ||||||||||||||||||||
Point estimate |
-0.65
|
||||||||||||||||||||
Confidence interval |
|||||||||||||||||||||
level |
95% | ||||||||||||||||||||
sides |
2-sided
|
||||||||||||||||||||
lower limit |
-1.27 | ||||||||||||||||||||
upper limit |
-0.02 | ||||||||||||||||||||
Statistical analysis title |
Comparison by treatment arm | ||||||||||||||||||||
Statistical analysis description |
ANOVA model included factors treatment group, gender and surgeon.
|
||||||||||||||||||||
Comparison groups |
Standard NMB and Standard Insufflation Pressure v Deep NMB and Low Insufflation Pressure
|
||||||||||||||||||||
Number of subjects included in analysis |
58
|
||||||||||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||||||||||
Analysis type |
other | ||||||||||||||||||||
Method |
|||||||||||||||||||||
Parameter type |
Difference in LS Means | ||||||||||||||||||||
Point estimate |
-0.15
|
||||||||||||||||||||
Confidence interval |
|||||||||||||||||||||
level |
95% | ||||||||||||||||||||
sides |
2-sided
|
||||||||||||||||||||
lower limit |
-0.84 | ||||||||||||||||||||
upper limit |
0.53 | ||||||||||||||||||||
Statistical analysis title |
Comparison by treatment arm | ||||||||||||||||||||
Statistical analysis description |
ANOVA model included factors treatment group, gender and surgeon.
|
||||||||||||||||||||
Comparison groups |
Standard NMB and Low Insufflation Pressure v Deep NMB and Standard Insufflation Pressure
|
||||||||||||||||||||
Number of subjects included in analysis |
62
|
||||||||||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||||||||||
Analysis type |
other | ||||||||||||||||||||
Method |
|||||||||||||||||||||
Parameter type |
Difference in LS Means | ||||||||||||||||||||
Point estimate |
-0.45
|
||||||||||||||||||||
Confidence interval |
|||||||||||||||||||||
level |
95% | ||||||||||||||||||||
sides |
2-sided
|
||||||||||||||||||||
lower limit |
-1.15 | ||||||||||||||||||||
upper limit |
0.26 | ||||||||||||||||||||
Statistical analysis title |
Comparison by treatment arm | ||||||||||||||||||||
Statistical analysis description |
ANOVA model included factors treatment group, gender and surgeon.
|
||||||||||||||||||||
Comparison groups |
Standard NMB and Low Insufflation Pressure v Deep NMB and Low Insufflation Pressure
|
||||||||||||||||||||
Number of subjects included in analysis |
49
|
||||||||||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||||||||||
Analysis type |
other | ||||||||||||||||||||
Method |
|||||||||||||||||||||
Parameter type |
Difference in LS Means | ||||||||||||||||||||
Point estimate |
0.05
|
||||||||||||||||||||
Confidence interval |
|||||||||||||||||||||
level |
95% | ||||||||||||||||||||
sides |
2-sided
|
||||||||||||||||||||
lower limit |
-0.69 | ||||||||||||||||||||
upper limit |
0.78 | ||||||||||||||||||||
Statistical analysis title |
Comparison by treatment arm | ||||||||||||||||||||
Statistical analysis description |
ANOVA model included factors treatment group, gender and surgeon.
|
||||||||||||||||||||
Comparison groups |
Deep NMB and Standard Insufflation Pressure v Deep NMB and Low Insufflation Pressure
|
||||||||||||||||||||
Number of subjects included in analysis |
65
|
||||||||||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||||||||||
Analysis type |
other | ||||||||||||||||||||
Method |
|||||||||||||||||||||
Parameter type |
Difference in LS Means | ||||||||||||||||||||
Point estimate |
0.49
|
||||||||||||||||||||
Confidence interval |
|||||||||||||||||||||
level |
95% | ||||||||||||||||||||
sides |
2-sided
|
||||||||||||||||||||
lower limit |
-0.17 | ||||||||||||||||||||
upper limit |
1.16 |
|
|||||||||||||
End point title |
Score on surgeon's assessment of overall satisfaction with the visibility of the surgical field: By depth of NMB (standard, deep) | ||||||||||||
End point description |
At the end of the procedure the surgeon responds to the following question, using an 11-point scale from 0 (poor, unacceptable visibility) to 10 (excellent): "How satisfied were you overall with the visual field during the surgery you just performed?" If at any time the surgeon requests a rescue intervention, the surgeon will rate his overall satisfaction with the visibility of the surgical field according to his opinion, but if a rescue intervention has been applied, that individual patient will be counted with a score of zero in the analysis. Population for analysis was randomized participants with available data who had NMB and pneumoperitoneum for laparoscopic surgery, and did not convert to open surgery before NMB and/or pressure application. Participants were included in the treatment arm to which they were randomized.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
End of surgery (Day 1)
|
||||||||||||
|
|||||||||||||
Statistical analysis title |
Comparison by NMB (standard, deep) | ||||||||||||
Statistical analysis description |
ANCOVA model included factors depth of NMB, level of pressure, surgeon and BMI.
|
||||||||||||
Comparison groups |
Deep NMB v Standard NMB
|
||||||||||||
Number of subjects included in analysis |
120
|
||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||
Analysis type |
other | ||||||||||||
P-value |
= 0.063 [2] | ||||||||||||
Method |
ANCOVA | ||||||||||||
Parameter type |
Difference in LS Means | ||||||||||||
Point estimate |
0.91
|
||||||||||||
Confidence interval |
|||||||||||||
level |
95% | ||||||||||||
sides |
2-sided
|
||||||||||||
lower limit |
-0.05 | ||||||||||||
upper limit |
1.87 | ||||||||||||
Notes [2] - Not controlled for multiple testing. |
|
|||||||||||||
End point title |
Score on surgeon's assessment of the overall adequacy of muscle relaxation during surgery: By depth of NMB (standard, deep) | ||||||||||||
End point description |
At the end of the procedure the surgeon responds to the following question, using an 11-point scale from 0 (poor, unacceptable muscle relaxation, required intervention) to 10 (excellent): "How do you rate the overall adequacy of muscle relaxation during the surgery you just performed?" Population for analysis was randomized participants with available data who had NMB and pneumoperitoneum for laparoscopic surgery, and did not convert to open surgery before NMB and/or pressure application. Participants were included in the treatment arm to which they were randomized.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
End of surgery (Day 1)
|
||||||||||||
|
|||||||||||||
Statistical analysis title |
Comparison by NMB (standard, deep) | ||||||||||||
Statistical analysis description |
ANCOVA model included factors depth of NMB, level of pressure, surgeon and BMI.
|
||||||||||||
Comparison groups |
Deep NMB v Standard NMB
|
||||||||||||
Number of subjects included in analysis |
120
|
||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||
Analysis type |
other | ||||||||||||
P-value |
= 0.004 [3] | ||||||||||||
Method |
ANCOVA | ||||||||||||
Parameter type |
Difference in LS Means | ||||||||||||
Point estimate |
0.82
|
||||||||||||
Confidence interval |
|||||||||||||
level |
95% | ||||||||||||
sides |
2-sided
|
||||||||||||
lower limit |
0.27 | ||||||||||||
upper limit |
1.37 | ||||||||||||
Notes [3] - Not controlled for multiple testing. |
|
|||||||||||||
End point title |
Score on surgeon's assessment of the overall adequacy of insufflation pressure during surgery: By depth of NMB (standard, deep) | ||||||||||||
End point description |
At the end of the procedure the surgeon responds to the following question, using an 11-point scale from 0 (poor, unacceptable insufflation pressure, required intervention) to 10 (excellent): "How do you rate the overall adequacy of insufflation pressure during the surgery you just performed?" Analysis population was randomized participants with available data who had NMB and pneumoperitoneum for laparoscopic surgery, and did not convert to open surgery before NMB and/or pressure application. Participants were included in the treatment arm to which they were randomized.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
End of surgery (Day 1)
|
||||||||||||
|
|||||||||||||
Statistical analysis title |
Comparison by NMB (standard, deep) | ||||||||||||
Statistical analysis description |
ANCOVA model included factors depth of NMB, level of pressure, surgeon and BMI.
|
||||||||||||
Comparison groups |
Deep NMB v Standard NMB
|
||||||||||||
Number of subjects included in analysis |
120
|
||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||
Analysis type |
other | ||||||||||||
P-value |
= 0.006 [4] | ||||||||||||
Method |
ANCOVA | ||||||||||||
Parameter type |
Difference in LS Means | ||||||||||||
Point estimate |
1.12
|
||||||||||||
Confidence interval |
|||||||||||||
level |
95% | ||||||||||||
sides |
2-sided
|
||||||||||||
lower limit |
0.32 | ||||||||||||
upper limit |
1.92 | ||||||||||||
Notes [4] - Not controlled for multiple testing. |
|
|||||||||||||
End point title |
Number of times participant's movements or increased muscle tone interfered with the surgical conditions during laparoscopy: By depth of NMB (standard, deep) | ||||||||||||
End point description |
At the end of the procedure the surgeon responds to the following question: “How many times did patient's movements (coughing, bucking, hiccup) or increased muscle tone (resistance, difficulty to close fasciae or skin) interfere with your surgery?” Population for analysis was randomized participants with available data who had NMB and pneumoperitoneum for laparoscopic surgery, and did not convert to open surgery before NMB and/or pressure application. Participants were included in the treatment arm to which they were randomized.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
During surgery, approximate duration of 1-2 hours (Day 1)
|
||||||||||||
|
|||||||||||||
Statistical analysis title |
Comparison by NMB (standard, deep) | ||||||||||||
Statistical analysis description |
ANCOVA model included factors depth of NMB, level of pressure, surgeon and BMI.
|
||||||||||||
Comparison groups |
Deep NMB v Standard NMB
|
||||||||||||
Number of subjects included in analysis |
119
|
||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||
Analysis type |
other | ||||||||||||
P-value |
= 0.073 [5] | ||||||||||||
Method |
ANCOVA | ||||||||||||
Parameter type |
Difference in LS Means | ||||||||||||
Point estimate |
-0.61
|
||||||||||||
Confidence interval |
|||||||||||||
level |
95% | ||||||||||||
sides |
2-sided
|
||||||||||||
lower limit |
-1.27 | ||||||||||||
upper limit |
0.06 | ||||||||||||
Notes [5] - Not controlled for multiple testing. |
|
|||||||||||||
End point title |
Score on surgeon's assessment of the effect participant's movements during surgery had on the overall surgical procedure: By depth of NMB (standard, deep) | ||||||||||||
End point description |
At the end of the procedure the surgeon responds to the following question, using an 11-point scale from 0 (extremely disruptive) to 10 (not disruptive): "How did the patient movements described above disrupt your surgical performance?" This refers to participant movements during surgery. Population for analysis was randomized participants with available data who had NMB and pneumoperitoneum for laparoscopic surgery, and did not convert to open surgery before NMB and/or pressure application. Participants were included in the treatment arm to which they were randomized.
|
||||||||||||
End point type |
Secondary
|
||||||||||||
End point timeframe |
End of surgery (Day 1)
|
||||||||||||
|
|||||||||||||
Statistical analysis title |
Comparison by NMB (standard, deep) | ||||||||||||
Statistical analysis description |
ANCOVA model included factors depth of NMB, level of pressure, surgeon and BMI.
|
||||||||||||
Comparison groups |
Deep NMB v Standard NMB
|
||||||||||||
Number of subjects included in analysis |
120
|
||||||||||||
Analysis specification |
Pre-specified
|
||||||||||||
Analysis type |
other | ||||||||||||
P-value |
= 0.009 [6] | ||||||||||||
Method |
ANCOVA | ||||||||||||
Parameter type |
Difference in LS Means | ||||||||||||
Point estimate |
0.74
|
||||||||||||
Confidence interval |
|||||||||||||
level |
95% | ||||||||||||
sides |
2-sided
|
||||||||||||
lower limit |
0.19 | ||||||||||||
upper limit |
1.28 | ||||||||||||
Notes [6] - Not controlled for multiple testing. |
|
|||||||||||||||||||||||||||||||
End point title |
Number of participants with rescue actions performed during surgery in order to improve insufficient surgical conditions: By treatment arm | ||||||||||||||||||||||||||||||
End point description |
During procedure, surgeon could request modification to randomized treatment conditions (“rescue intervention”), if surgeon considered surgical conditions unacceptable. For participant on standard NMB, preferred rescue intervention was increase of NMB from standard to deep level; second option, if available, was to raise insufflation pressure from low to standard. If the participant was already on deep NMB, preferred option, if available, was to raise insufflation pressure from low to standard. The anesthetist recorded any rescue actions performed. This measure presents number of participants: with any rescue action performed, with rescue change in depth of NMB, with rescue change in insufflation pressure level. Analysis included randomized participants with available data who had NMB and pneumoperitoneum for laparoscopic surgery, and did not convert to open surgery before NMB and/or pressure application. Participants were included in the treatment arm to which they were randomized.
|
||||||||||||||||||||||||||||||
End point type |
Secondary
|
||||||||||||||||||||||||||||||
End point timeframe |
During surgery, approximate duration of 1-2 hours (Day 1)
|
||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||
No statistical analyses for this end point |
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
End point title |
Participant's daily assessment of overall pain at rest during post operative period: By treatment arm | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
End point description |
Participants rated pain at 1, 2, 4, 24 and 48 hours after the administration of sugammadex on day of surgery (Day 1), and daily (in the morning) from Day 3 to Day 8. Pain rating was made using an 11-point scale from 0 (no pain) to 10 (severe pain). Separate ratings were made for overall pain at rest, pain when provoked (e.g., due to participant transition from lying to sitting position) and shoulder pain at rest. This measure summarizes the assessment of overall pain at rest for the study days following the surgery. Analysis population was randomized participants with available data who had NMB or pneumoperitoneum for laparoscopic surgery, or received sugammadex. Participants were included in arm corresponding to treatment actually received, which in case of rescue intervention was the post-intervention condition.
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
End point type |
Secondary
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
End point timeframe |
Days 2 to 8
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
No statistical analyses for this end point |
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
End point title |
Participant's daily assessment of provoked pain during post operative period: By treatment arm | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
End point description |
Participants rated pain at 1, 2, 4, 24 and 48 hours after the administration of sugammadex on day of surgery (Day 1), and daily (in the morning) from Day 3 to Day 8. Pain rating was made using an 11-point scale from 0 (no pain) to 10 (severe pain). Separate ratings were made for overall pain at rest, pain when provoked (e.g., due to participant transition from lying to sitting position) and shoulder pain at rest. This measure summarizes the assessment of provoked pain for the study days following the surgery. Population for analysis included randomized participants with available data who had NMB or pneumoperitoneum for laparoscopic surgery, or received sugammadex. Participants were included in arm corresponding to treatment actually received, which in case of rescue intervention was the post-intervention condition.
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
End point type |
Secondary
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
End point timeframe |
Days 2 to 8
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
No statistical analyses for this end point |
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
End point title |
Participant's daily assessment of shoulder pain during post operative period: By treatment arm | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
End point description |
Participants rated pain at 1, 2, 4, 24 and 48 hours after the administration of sugammadex on day of surgery (Day 1), and daily (in the morning) from Day 3 to Day 8. Pain rating was made using an 11-point scale from 0 (no pain) to 10 (severe pain). Separate ratings were made for overall pain at rest, pain when provoked (e.g., due to participant transition from lying to sitting position) and shoulder pain at rest. This measure summarizes the assessment of shoulder pain for the study days following the surgery. Population for analysis was randomized participants with available data who had NMB or pneumoperitoneum for laparoscopic surgery, or received sugammadex. Participants were included in arm corresponding to treatment actually received, which in case of rescue intervention was the post-intervention condition
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
End point type |
Secondary
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
End point timeframe |
Days 2 to 8
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
No statistical analyses for this end point |
|
|||||||||||||||||||||||||||||||||||||||||
End point title |
Number of participants using pain/analgesic medication during post operative period: By treatment arm | ||||||||||||||||||||||||||||||||||||||||
End point description |
Post operative use of pain/analgesic medication by participant through Day 8 was recorded. Population for analysis was randomized participants with available data who had NMB or pneumoperitoneum for laparoscopic surgery, or received sugammadex. Participants were included in arm corresponding to treatment actually received, which in case of rescue intervention was the post-intervention condition.
|
||||||||||||||||||||||||||||||||||||||||
End point type |
Secondary
|
||||||||||||||||||||||||||||||||||||||||
End point timeframe |
Up to Day 8
|
||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||
No statistical analyses for this end point |
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Adverse events information
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Timeframe for reporting adverse events |
Up to Day 8
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Adverse event reporting additional description |
Includes randomized participants with available data who had NMB or pneumoperitoneum for laparoscopic surgery, or received sugammadex. Participants were included in arm corresponding to treatment actually received, which in case of rescue intervention was the post-intervention condition.
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Assessment type |
Systematic | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary name |
MedDRA | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
17.0
|
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Reporting groups
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Standard NMB and Standard Insufflation Pressure
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group description |
Treatment condition for this reporting group is Standard NMB (depth of blockade at a targeted TOF ratio of 10%)/Standard insufflation pressure (starting pressure of 12 mmHg). | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Deep NMB and Low Insufflation Pressure
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group description |
Treatment condition for this reporting group is Deep NMB (depth of blockade of 1-2 PTCs)/Low insufflation pressure (starting pressure of 8 mmHg). | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Deep NMB and Standard Insufflation Pressure
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group description |
Treatment condition for this reporting group is Deep NMB (depth of blockade of 1-2 PTCs)/Standard insufflation pressure (starting pressure of 12 mmHg). | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Standard NMB and Low Insufflation Pressure
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group description |
Treatment condition for this reporting group is Standard NMB (depth of blockade at a targeted TOF ratio of 10%)/Low insufflation pressure (starting pressure of 8 mmHg). | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Frequency threshold for reporting non-serious adverse events: 5% | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Substantial protocol amendments (globally) |
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Were there any global substantial amendments to the protocol? Yes | |||
Date |
Amendment |
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08 Oct 2012 |
Amendment 01: Primary reason for amendment was to revise definition of standard NMB, methodology for administration of rocuronium to maintain NMB and scoring instruction on surgical conditions questionnaire. |
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10 Jun 2013 |
Amendment 02: Primary reason for amendment was to allow prematurely discontinued subjects with missing outcome for the primary and/or key secondary endpoints to be replaced. |
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06 Aug 2013 |
Amendment 03: Primary reason for amendment was to revise two exclusion criteria. |
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Interruptions (globally) |
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Were there any global interruptions to the trial? No | |||
Limitations and caveats |
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Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data. | |||
None reported |