Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Deep neuromuscular blockade and surgical conditions during laparoscopic ventral hernia repair: A randomised, blinded study

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Pitfalls of clinical practice guidelines in the era of broken science: Let's raise the standards

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Device or target? A paradigm shift in airway management: Implications for guidelines, clinical practice and teaching

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. European guidelines on perioperative venous thromboembolism prophylaxis

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. European guidelines on perioperative venous thromboembolism prophylaxis: Inferior vena cava filters

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Adverse reactions of dimethyl sulfoxide in humans: a systematic review [version 2; peer review: 2 approved with reservations

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. A national center for persistent severe pain after groin hernia repair: Five-year prospective data

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Response to Comment on "Polypropylene Mesh and Fertility"

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Groin hernia in children

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  5. Laparoscopic versus open repair of groin hernias in children: a systematic review and meta-analysis

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer

BACKGROUND: Laparoscopic ventral hernia repair is a common surgical procedure. However, muscle contractions and general muscle tension may impair the surgical view and cause difficulties suturing the hernial defect. Deep neuromuscular blockade (NMB) paralyses the abdominal wall muscles and may help to create better surgical conditions.

OBJECTIVES: The current study investigated if deep compared with no NMB improved the surgical view during laparoscopic ventral hernia repair.

DESIGN: Crossover study.

SETTING: The study was carried out at Herlev and Gentofte Hospital, University of Copenhagen, Denmark and conducted from May 2015 until February 2017.

PARTICIPANTS: A total of 34 patients were randomised in an investigator-initiated, assessor-blinded crossover design of deep vs. no NMB during laparoscopic ventral hernia repair.

INCLUSION CRITERIA: Adults scheduled for elective laparoscopic ventral hernia repair.

EXCLUSION CRITERIA: Known allergy to any study medication, known homozygous variants in the butyrylcholinesterase gene, severe renal disease, neuromuscular disease, lactating or pregnant women, any indication for rapid sequence induction.

INTERVENTIONS: Deep NMB was established with rocuronium and reversed with sugammadex. Anaesthesia was conducted with propofol and remifentanil.

MAIN OUTCOME MEASURES: The primary outcome was evaluation of surgical view assessed on a five-point rating scale. Other outcomes included the surgical conditions during laparoscopic suturing of the hernia defect.

RESULTS: We found no difference in ratings for the surgical view when comparing deep with no NMB: mean -0.1 (95% confidence interval -0.4 to 0.2) (P = 0.521, paired t test). However, deep compared with no NMB improved the rating score for surgical conditions while suturing the hernia defect (P = 0.012, Mann-Whitney U test). No differences were found in either total length of surgery (P = 0.76) or hernia suturing time (P = 0.81).

CONCLUSION: Deep compared with no NMB did not change the rating score of the surgical view immediately after introduction of trocars during laparoscopic ventral hernia repair, but the surgical condition were improved during suturing of the hernia.

TRIAL REGISTRATION: ClinicalTrials.gov, NCT02247466.

OriginalsprogEngelsk
TidsskriftEuropean Journal of Anaesthesiology
Vol/bind35
Udgave nummer11
Sider (fra-til)876-882
Antal sider7
ISSN0265-0215
DOI
StatusUdgivet - nov. 2018

ID: 56441760