• Roar Medici, Matias V Madsen, Sami Asadzadeh, Søren Følsgaard, Jacob Rosenberg, and Mona R Gätke.
• Anæstesiologisk Afdeling I, Herlev Hospital, Herlev Ringvej 75, 2730 Herlev, Denmark. roar.borregaard.medici.01@regionh.dk.
• Dan Med J. 2015 Aug 1; 62 (8): A5120.

IntroductionLaparoscopic 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.MethodsThis 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.ConclusionThis 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.FundingThe study is funded by a research grant from the Investigator Initiated Studies Program of Merck Sharp & Dohme Corp.Trial RegistrationNCT02247466.

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