title: Neuromuscular blockade during laparoscopic ventral herniotomy: protocol for a randomised controlled trial.
abstract: BACKGROUND
  Laparoscopic herniotomy is the preferred technique for some ventral hernias. Several factors may influence the surgical conditions, one being the depth of neuromuscular blockade (NMB) applied. We hypothesised that deep neuromuscular blockade defined as a post-tetanic count below eight would provide a better surgical workspace.
  
  
  METHODS
  This was an investigator-initiated, assessor- and patient-blinded randomised cross-over study. A total of 34 patients with planned laparoscopic umbilical, incisional and linea alba herniotomy were studied. Patients would be randomised to receive deep NMB followed by no NMB, or no NMB followed by deep NMB. Our primary outcome was improvement of the surgical workspace (rated on a five-point scale) estimated as the difference between the workspace during deep NMB and the workspace without NMB. Secondary outcomes included, among others, surgeon's rating of surgical conditions during suturing, duration of surgery and duration of the suturing of the hernia.
  
  
  CONCLUSIONS
  This randomised cross-over study investigated a potential effect on the surgical workspace in laparoscopic ventral herniotomy using deep NMB compared with no NMB. The study may provide knowledge relevant to other laparoscopic techniques.
  
  
  BACKGROUND
  The study is funded by a research grant from the Investigator Initiated Studies Program of Merck Sharp & Dohme Corp.
  
  
  BACKGROUND
  NCT02247466.
authors.affiliation: Anæstesiologisk Afdeling I, Herlev Hospital, Herlev Ringvej 75, 2730 Herlev, Denmark. roar.borregaard.medici.01@regionh.dk.
authors.forename: Roar
authors.initials: R
authors.lastname: Medici
authors.forename: Matias V
authors.initials: MV
authors.lastname: Madsen
authors.forename: Sami
authors.initials: S
authors.lastname: Asadzadeh
authors.forename: Søren
authors.initials: S
authors.lastname: Følsgaard
authors.forename: Jacob
authors.initials: J
authors.lastname: Rosenberg
authors.forename: Mona R
authors.initials: MR
authors.lastname: Gätke
mesh_terms: D000328:Adult; D002985:Clinical Protocols; D018592:Cross-Over Studies; D004311:Double-Blind Method; D006555:Hernia, Ventral / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D007432:Intraoperative Period; D010535:Laparoscopy / Q000379:methods*; D016343:Monitoring, Intraoperative / Q000379:methods; D019148:Neuromuscular Blockade / Q000379:methods*; D061646:Operative Time; D013536:Suture Techniques / Q000706:statistics & numerical data; D016896:Treatment Outcome