Deep Neuromuscular Blockade Improves Laparoscopic Surgical Conditions: A Randomized, Controlled Study

Rosenberg, Jacob; Herring, W. Joseph; Blobner, Manfred; Mulier, J. P.; Rahe‐Meyer, Niels; Woo, Tiffany; Li, Michael K.; Grobara, Peter; Assaid, Christopher; Fennema, Hein; Szegedi, Armin

doi:10.1007/s12325-017-0495-x

Cited by 47 publications

(41 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…condKoo [17]2016General surgeryDeep versus moderate NMB4 point1 (excellent)–4 (poor)UnknownEnd of surgery% subopt./opt. cond., increase IAP ( n )Kim [25]2016General surgeryDeep versus moderate NMB5 point a 1 (extremely poor)–5 (optimal)UnknownEnd of surgerySRS, titrated IAPRosenberg [18]2017General surgeryDeep versus moderate NMB11 point0 (poor)–10 (excellent)UnknownEnd of surgeryMean SRS, SRS distributionOzdemir [22]2017General surgeryDeep versus moderate NMB5 point a 1 (extremely poor)–5 (optimal)Unknown15 minMean SRS, SRS distributionOzdemir [23]2017General surgeryDeep versus moderate NMB5 point a 1 (extremely poor)–5 (optimal)Unknown15 minMean SRS, SRS distribution SRS surgical rating scale, % subopt ./ opt. Cond .…”

Section: Resultsmentioning

confidence: 99%

“…Some only reported the percentage of unacceptable surgical conditions, which was generally the frequency of scores on the lower half of the surgical rating scale [3, 17, 20]. In addition, the number and moments of scoring differed considerably, with some studies scoring every 10 or 15 min [1, 2, 4, 7, 19, 20], while others scored one overall score at the end of surgery [3, 5, 8, 15, 17, 18, 21]. Some reports do not mention a scoring interval at all [16, 24].…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

The use of surgical rating scales for the evaluation of surgical working conditions during laparoscopic surgery: a scoping review

et al. 2018

View full text Add to dashboard Cite

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The use of surgical rating scales for the evaluation of surgical working conditions during laparoscopic surgery: a scoping review

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Les critères secondaires étaient l'EEC thoracique, le nombre de bolus demandés, les événements chirurgicaux peropératoires, les scores de douleur (jusqu'à 12 h postopératoires) et la durée de la chirurgie. Résultats L'EEC abdominale médiane [écart interquartile] n'était pas différente entre les groupes intervention (4 [4][5]) et témoin (4 [4][5]) (différence médiane, 0; intervalle de confiance 95 %, 0 à 0; P = 0,45). L'EEC thoracique était de 4 dans les deux groupes (P = 0,23).…”

Section: Résuméunclassified

On-demand versus continuous rocuronium infusion for deep neuromuscular relaxation in patients undergoing thoraco-laparoscopic esophagectomy: a randomized-controlled clinical trial (DEPTH)

Veelo

Gisbertz

Binnekade

et al. 2019

Can J Anesth/J Can Anesth

Self Cite

View full text Add to dashboard Cite

Purpose Deep neuromuscular blockade (NMB) can improve surgical conditions and possibly pain after lowrisk laparoscopic surgery. We hypothesized that targeting a deep level of NMB by a continuous compared with an on-demand infusion of rocuronium could improve surgical conditions in patients undergoing thoraco-laparoscopic esophagectomy. Methods In this single-centre, randomized-controlled, double-blind trial, patients received either a continuous infusion of rocuronium 0.6 mgÁkg-1 Áhr-1 (intervention) or NaCl 0.9% (control). Both surgeon and anesthesiologist were blinded to group assignment and the train-of-four measurements. Open-label rocuronium was given if requested (i.e., on-demand) by the surgeon. At the end of surgery, sugammadex was given if necessary to reverse the NMB. The primary outcome was the quality of surgical conditions during the abdominal phase of the operation as measured by the surgical rating scale (SRS). Secondary outcomes included the thoracic SRS, number of on-demand boluses, intraoperative surgical events, pain scores (up to 12 hr postoperatively), and duration of surgery. Results The median [interquartile range] abdominal SRS was not different between the intervention (4 [4-5]) and control (4 [4-5]) groups (median difference, 0; 95% confidence interval, 0 to 0; P = 0.45). The thoracic SRS was 4 [4-4] in both groups (P = 0.23). The median number of rocuronium bolus requests was higher in the control group compared with the intervention group (3 [3-6] vs 1 [0-2], respectively; P \ 0.01). There were no between-group Electronic supplementary material The online version of this article (

show abstract

“…Many studies examined the influence of the neuromuscular block (NMB) on the quality of operating conditions [1][2][3][4][5][6][7][8][9][10]. Therefore, intraabdominal measurements, e.g., of abdominal volume, were performed [2,5,6], and several scores were developed [4,8,11].…”

Section: Introductionmentioning

confidence: 99%

Depth of Neuromuscular Block Is Not Associated with Abdominal Wall Distention or Surgical Conditions during Gynecologic Laparoscopic Operations. A Prospective Trial

Soltész

Mathes

Anapolski

et al. 2020

JCM

View full text Add to dashboard Cite

The influence of the degree of a neuromuscular block (NMB) on surgical operating conditions during laparoscopic surgery is debated controversially. The extent of abdominal distension during the time course of the NMB was assessed as a new measurement tool. In 60 patients scheduled for gynecologic laparoscopic surgery, the increase of the abdominal wall length induced by the capnoperitoneum was measured at 5 degrees of the NMB: intense NMB—post-tetanic count (PTC) = 0; deep NMB—train-of-four count (TOF) = 0 and PTC = 1–5; medium NMB—PTC > 5 and TOF = 0–1; shallow NMB—TOF > 1; full recovery—train-of-four ratio TOFR > 90%. Simultaneously, the quality of operating conditions was assessed with a standardized rating scale (SRS) reaching from 1 (extremely poor conditions) to 5 (excellent conditions). Fifty patients could be included in the analysis. The abdominal wall length increased by 10–13 mm induced by the capnoperitoneum. SRS was higher during intense NMB (4.7 ± 0.5) vs. full recovery (4.5 ± 0.5) (mean ± SD; p = 0.025). Generally, an intense NMB did not increase abdominal wall length induced by capnoperitoneum. Additionally, its influence on the quality of surgical operating conditions seems to be of minor clinical relevance.

show abstract

Deep Neuromuscular Blockade Improves Laparoscopic Surgical Conditions: A Randomized, Controlled Study

Abstract: Merck Sharp and Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA.

Cited by 47 publications

References 14 publications

The use of surgical rating scales for the evaluation of surgical working conditions during laparoscopic surgery: a scoping review

The use of surgical rating scales for the evaluation of surgical working conditions during laparoscopic surgery: a scoping review

On-demand versus continuous rocuronium infusion for deep neuromuscular relaxation in patients undergoing thoraco-laparoscopic esophagectomy: a randomized-controlled clinical trial (DEPTH)

Depth of Neuromuscular Block Is Not Associated with Abdominal Wall Distention or Surgical Conditions during Gynecologic Laparoscopic Operations. A Prospective Trial

Contact Info

Product

Resources

About