Aaron F Kopman1, Mohamed Naguib2. 1. New York City, NY, USA. 2. Department of General Anesthesiology, Cleveland Clinic, Cleveland, OH, USA.
Abstract
BACKGROUND: There is currently a controversy regarding the need for and clinical benefit of maintaining deep neuromuscular block (post-tetanic counts of 1 or 2) vs. moderate block (train-of-four counts of 1-3) for routine laparoscopic surgery. Two recent review articles on this subject arrived at rather different conclusions. This manuscript is part of Pro/Con debate from the authors of these two reviews. METHODS: The authors of the Pro and Con sides of the debate had the opportunity to read each other manuscripts and worked from the same basic database of references. RESULTS: The present authors could find only one peer-reviewed paper which presented objective evidence supporting the proposition that deep neuromuscular block provides superior operating conditions for the surgeon during laparoscopic surgery. CONCLUSION: There is not enough good evidence available to justify the routine use of deep neuromuscular block for laparoscopic surgery and the associated expense of high-dose sugammadex.
BACKGROUND: There is currently a controversy regarding the need for and clinical benefit of maintaining deep neuromuscular block (post-tetanic counts of 1 or 2) vs. moderate block (train-of-four counts of 1-3) for routine laparoscopic surgery. Two recent review articles on this subject arrived at rather different conclusions. This manuscript is part of Pro/Con debate from the authors of these two reviews. METHODS: The authors of the Pro and Con sides of the debate had the opportunity to read each other manuscripts and worked from the same basic database of references. RESULTS: The present authors could find only one peer-reviewed paper which presented objective evidence supporting the proposition that deep neuromuscular block provides superior operating conditions for the surgeon during laparoscopic surgery. CONCLUSION: There is not enough good evidence available to justify the routine use of deep neuromuscular block for laparoscopic surgery and the associated expense of high-dose sugammadex.
Authors: Oscar Diaz-Cambronero; Blas Flor Lorente; Guido Mazzinari; Maria Vila Montañes; Nuria García Gregorio; Daniel Robles Hernandez; Luis Enrique Olmedilla Arnal; Maria Pilar Argente Navarro; Marcus J Schultz; Carlos L Errando Journal: Surg Endosc Date: 2018-06-27 Impact factor: 4.584
Authors: Bart Torensma; Chris H Martini; Martijn Boon; Erik Olofsen; Bas In 't Veld; Ronald S L Liem; Mireille T T Knook; Dingeman J Swank; Albert Dahan Journal: PLoS One Date: 2016-12-09 Impact factor: 3.240