Introduction
Methods
Patients
Ethics
Randomization and blinding
Anesthesia
Surgical procedure
Evaluation of perioperative conditions
Outcome measures
Sample size calculation and data analysis
Results
Patient characteristics
Deep NMB (n = 15) | Standard NMB (n = 19) |
p value | |
---|---|---|---|
Male:female | 9:6 | 13:6 | 0.61 |
BMI | 24.7 ± 3.7 | 26.2 ± 3.7 | 0.22 |
Right kidney | 5 (33%) | 4 (21%) | 0.42 |
Per- and postoperative outcomes
Deep NMB (n = 15) | Standard NMB (n = 19) |
p value | |
---|---|---|---|
Mean Surgical Rating Scale (0–5) | |||
SRS first trocar | 4.3 ± 0.7 | 3.8 ± 0.8 | 0.07 |
SRS third trocar | 4.3 ± 0.7 | 3.9 ± 0.8 | 0.13 |
SRS at 15 min | 4.5 ± 0.5 | 4.1 ± 0.6 |
0.03
|
SRS at 30 min | 4.4 ± 0.5 | 4.2 ± 0.5 | 0.12 |
SRS at 45 min | 4.4 ± 0.5 | 4.2 ± 0.5 | 0.12 |
SRS at 60 min | |||
SRS at 75 min | |||
Overall SRS1
| 4.5 ± 0.5 | 4.0 ± 0.4 |
0.01
|
Mean Intra-abdominal pressure (mmHg) | |||
IAP first trocar | 6.0 | 6.0 | 1.0 |
IAP third trocar | 6.4 ± 1.1 | 7.2 ± 2.0 | 0.21 |
IAP at 15 min | 6.5 ± 1.2 | 7.4 ± 2.1 | 0.18 |
IAP at 30 min | 6.8 ± 1.5 | 7.7 ± 2.3 | 0.21 |
IAP at 45 min | 6.9 ± 1.8 | 7.8 ± 2.5 | 0.26 |
IAP at 60 min | |||
IAP at 75 min | |||
Primary surgeon <50 LDNs | 6 | 11 | 0.49 |
Operation duration (min) | 143 ± 34.7 | 159 ± 45.4 | 0.26 |
PNP duration (min) | 136 ± 63.9 | 138 ± 47.0 | 0.89 |
EBL (ml) | 137 ± 199 | 331 ± 603 | 0.21 |
First WIT (s) | 290 ± 118 | 372 ± 293 | 0.30 |
Deep NMB (n = 15) | Standard NMB (n = 19) |
p value | |
---|---|---|---|
Overall maximum pain score | |||
Postoperative 1 h | 4.5 ± 2.5 | 4.8 ± 2.6 | 0.74 |
Postoperative day 1 | 4.5 ± 2.6 | 4.4 ± 2.4 | 0.91 |
Superficial wound component | |||
Postoperative 1 h | 1.6 ± 1.4 | 1.2 ± 1.3 | 0.48 |
Postoperative 1 h (movement) | 2.3 ± 1.6 | 2.8 ± 2.2 | 0.44 |
Postoperative day 1 | 1.0 ± 1.3 | 1.9 ± 1.8 | 0.13 |
Postoperative day 1 (movement) | 2.3 ± 1.9 | 3.1 ± 2.4 | 0.27 |
Deep intra-abdominal component | |||
Postoperative 1 h | 1.5 ± 1.7 | 1.1 ± 1.0 | 0.53 |
Postoperative 1 h (movement) | 2.1 ± 1.9 | 1.8 ± 1.4 | 0.61 |
Postoperative day 1 | 1.2 ± 1.4 | 1.3 ± 1.4 | 0.79 |
Postoperative day 1 (movement) | 1.9 ± 2.0 | 2.3 ± 1.8 | 0.60 |
Referred shoulder component | |||
Postoperative 1 h | 0.0 ± 0.0 | 0.1 ± 0.3 | 0.20 |
Postoperative 1 h (movement) | 0.1 ± 0.5 | 0.2 ± 0.4 | 0.87 |
Postoperative day 1 | 1.7 ± 2.5 | 1.9 ± 2.2 | 0.80 |
Postoperative day 1 (movement) | 2.0 ± 2.7 | 2.1 ± 2.7 | 0.89 |
Analgesic medication | |||
Opiate use day 0 (mg) | 17 | 19 | 0.55 |
Opiate use day 1 (mg) | 4 | 9 |
0.04
|
Opiate use day 2 (mg) | 1 | 3 | 0.19 |
Cumulative opiate use 48 h (mg) | 22 | 31 |
0.05
|
Safety
Deep NMB (n = 15) | Standard NMB (n = 19) |
p value | |
---|---|---|---|
Conversions | |||
Conversions to higher IAP | 7 | 10 | 1.0 |
8 mmHg | 3 | 2 | |
10 mmHg | 2 | 1 | |
12 mmHg | 2 | 7 | |
Conversion to ODN | 0 | 2 | 0.20 |
Intraoperative complications | 0 | 4 | 0.11 |
Arterial bleedinga
| 0 | 2 | |
Venous bleeding | 0 | 1 | |
Ureter transection | 1 | 1 | |
Postoperative complications | 0 | 3 | 0.61 |
Hematoma Pfannenstiehl | 0 | 1 | |
Vasovagal collaps | 0 | 1 | |
Transient neuralgia | 1 | 0 | |
Hypertension | 0 | 1 |