Deep neuromuscular block to optimize surgical space conditions during laparoscopic surgery: a systematic review and meta-analysis M.H. Bruintjes, E.V.

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Deep neuromuscular block to optimize surgical space conditions during laparoscopic surgery: a systematic review and meta-analysis M.H. Bruintjes, E.V. van Helden, A.E. Braat, A Dahan, G.J. Scheffer, C.J. van Laarhoven, M.C. Warlé British Journal of Anaesthesia Volume 118, Issue 6, Pages 834-842 (June 2017) DOI: 10.1093/bja/aex116 Copyright © 2017 The Author(s) Terms and Conditions

Fig 1 PRISMA flow diagram of study selection process. British Journal of Anaesthesia 2017 118, 834-842DOI: (10.1093/bja/aex116) Copyright © 2017 The Author(s) Terms and Conditions

Fig 2 Assessment of risk of bias. British Journal of Anaesthesia 2017 118, 834-842DOI: (10.1093/bja/aex116) Copyright © 2017 The Author(s) Terms and Conditions

Fig 3 Surgical space conditions are improved by the use of deep neuromuscular block (NMB). Forest plot of studies comparing surgical space conditions during laparoscopic procedures with deep NMB vs moderate, shallow, or no NMB. The effect size is calculated as the mean difference in surgical rating score (range 1–5) and corresponding 95% confidence intervals (95% CI). British Journal of Anaesthesia 2017 118, 834-842DOI: (10.1093/bja/aex116) Copyright © 2017 The Author(s) Terms and Conditions

Fig 4 The duration of surgery is not significantly decreased by the use of deep NMB. Forest plot of studies comparing the duration of surgery during laparoscopic procedures with deep vs moderate or no NMB. The effect size is calculated as the mean difference in duration of surgery in minutes and corresponding 95% confidence intervals (95% CI). British Journal of Anaesthesia 2017 118, 834-842DOI: (10.1093/bja/aex116) Copyright © 2017 The Author(s) Terms and Conditions

Fig 5 Postoperative pain in the postanaesthesia care unit is reduced by the use of deep neuromuscular block (NMB). Forest plot of studies comparing postoperative pain 1 h after laparoscopic procedures with deep NMB vs moderate NMB. The effect size is calculated as the mean difference in NRS (range 0–10) and corresponding 95% confidence intervals (95% CI). British Journal of Anaesthesia 2017 118, 834-842DOI: (10.1093/bja/aex116) Copyright © 2017 The Author(s) Terms and Conditions