Neuromuscular blockade during laparoscopic ventral herniotomy: protocol for a randomised controlled trial.

Area of Science:

• Surgical innovation
• Anesthesiology
• Minimally invasive surgery

Background:

• Laparoscopic ventral herniotomy is a preferred surgical technique.
• Surgical conditions during laparoscopy can be influenced by neuromuscular blockade (NMB) depth.
• Deep NMB, defined as a post-tetanic count below eight, was investigated for its impact on surgical workspace.

Purpose of the Study:

• To evaluate the effect of deep neuromuscular blockade (NMB) on surgical workspace during laparoscopic ventral herniotomy.
• To compare surgical conditions with deep NMB versus no NMB.
• To assess secondary outcomes including surgeon's rating, duration of surgery, and suturing time.

Main Methods:

• Investigator-initiated, blinded, randomized cross-over study.
• 34 patients undergoing laparoscopic umbilical, incisional, or linea alba herniotomy.
• Patients were randomized to receive deep NMB followed by no NMB, or vice versa.

Main Results:

• Deep NMB was associated with an improved surgical workspace compared to no NMB.
• The study measured workspace improvement on a five-point scale.
• Secondary outcomes related to surgical conditions and duration were also assessed.

Conclusions:

• Deep neuromuscular blockade enhances the surgical workspace in laparoscopic ventral herniotomy.
• This finding may have implications for other laparoscopic procedures.
• Further research can explore the broader applicability of deep NMB in laparoscopy.