SynthesisPloS one2023
Does deep neuromuscular blockade provide improved perioperative outcomes in adult patients? A systematic review and meta-analysis of randomized controlled trials.
Synthesis in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 16 citations in OpenAlex.
- Impact of neuromuscular blockade depth on postoperative systemic cytokine release: a systematic review and meta-analysis.Korean journal of anesthesiology · 2026Pooled it
- Deep neuromuscular blockade in adults undergoing an abdominal laparoscopic procedure.The Cochrane database of systematic reviews · 2024Pooled it
- Transversus abdominis plane block improved surgical conditions in neuromuscular blocker-free pediatric laparoscopic hernia repair: a randomized trial.Surgical endoscopy · 2026Trial
- [Anesthesia for robot-assisted surgery].Die Anaesthesiologie · 2026Review
- Deep versus moderate neuromuscular blockade on postoperative recovery quality: a systematic review and meta-analysis of randomized controlled trials.Journal of anesthesia · 2026Article
- From optimization of surgical conditions to modulation of systemic inflammation: revisiting the implications of deep neuromuscular blockade.Korean journal of anesthesiology · 2026Article
- Optimizing recovery in orthognathic surgery: the cohort study of impact of rocuronium-sugammadex on extubation and perioperative outcomes.Annals of medicine · 2025Article
- Equipotent Dose and Cost Comparison of Atracurium and Rocuronium in Laboratory Pigs Anesthetized with Propofol.Animals : an open access journal from MDPI · 2025Article
- Impact of temperature on ECFrontiers in medicine · 2025Article
- Deep Neuromuscular Block with Low Pressure Pneumoperitoneum in Laparoscopic Abdominal Surgeries: A Randomized Controlled Trial.Anesthesiology and pain medicine · 2024Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Deep neuromuscular blockade provides better surgical workspace conditions in laparoscopic surgery, but it is still not clear whether it improves perioperative outcomes, not to mention its role in other types of surgeries. We performed this systematic review and meta-analysis of randomized controlled trials to investigate whether deep neuromuscular blockade versus other more superficial levels of neuromuscular blockade provides improved perioperative outcomes in adult patients in all types of surgeries. Medline, Embase, Cochrane Central Register of Controlled Trials, and Google Scholar were searched from inception to June 25, 2022. Forty studies (3271 participants) were included. Deep neuromuscular blockade was associated with an increased rate of acceptable surgical condition (relative risk [RR]: 1.19, 95% confidence interval [CI]: [1.11, 1.27]), increased surgical condition score (MD: 0.52, 95% CI: [0.37, 0.67]), decreased rate of intraoperative movement (RR: 0.19, 95% CI: [0.10, 0.33]), fewer additional measures to improve the surgical condition (RR: 0.63, 95% CI: [0.43, 0.94]), and decreased pain score at 24 h (MD: -0.42, 95% CI: [-0.74, -0.10]). There was no significant difference in the intraoperative blood loss (MD: -22.80, 95% CI: [-48.83, 3.24]), duration of surgery (MD: -0.05, 95% CI: [-2.05, 1.95]), pain score at 48 h (MD: -0.49, 95% CI: [-1.03, 0.05]), or length of stay (MD: -0.05, 95% CI: [-0.19, 0.08]). These indicate that deep neuromuscular blockade improves surgical conditions and prevents intraoperative movement, and there is no sufficient evidence that deep neuromuscular blockade is associated with intraoperative blood loss, duration of surgery, complications, postoperative pain, and length of stay. More high-quality randomized controlled trials are needed, and more attention should be given to complications and the physiological mechanism behind deep neuromuscular blockade and postoperative outcomes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.