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A randomised controlled trial comparing deep neuromuscular blockade reversed with sugammadex with moderate neuromuscular block reversed with neostigmine

Anaesthesia May 17, 2020

Boggett S, Chahal R, Griffiths J, et al. - Given that deep neuromuscular block aims to improve operative conditions during laparoscopic surgery with a lower intra‐abdominal pressure, and there is conflicting evidence on whether meaningful improvements in quality of recovery happen beyond emergence, and if lower intra‐abdominal pressure is attained, so to address this topic, researchers performed this pragmatic randomised trial among adults undergoing elective laparoscopic surgery. The participants were assigned (1:1) to moderate neuromuscular block reversed with neostigmine, or deep neuromuscular block reversed with sugammadex. Cognitive recovery of the Postoperative Quality of Recovery Scale, 7 days post-surgery was defined as the primary outcome. Experts noted that at day 7, or at any other time‐point, there was no disparity in the Postoperative Quality of Recovery Scale cognitive domain. In terms of physiological, emotive, activities of daily living, nociception, or overall recovery, no significant difference was evident. Based on these findings, it was concluded that no improvement in quality of recovery was brought about, over a 1‐h duration, by deep neuromuscular block vs moderate neuromuscular block in operative laparoscopic surgery.

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