The effect of low- versus normal-pressure pneumoperitoneum during laparoscopic colorectal surgery on the early quality of recovery with perioperative care according to the enhanced recovery principles (RECOVER): study protocol for a randomized controlled study
Abstract Background There is increasing evidence for the use of lower insufflation pressures during laparoscopic surgery. Deep neuromuscular blockade allows for a safe reduction in intra-abdominal pressure without compromising the quality of the surgical field. While there is considerable evidence t...
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| Format: | Article |
| Language: | English |
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BMC
2020-06-01
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| Series: | Trials |
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| Online Access: | http://link.springer.com/article/10.1186/s13063-020-04496-8 |
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| author | Kim I. Albers Fatih Polat Ivo F. Panhuizen Marc M. J. Snoeck Gert-Jan Scheffer Hans D. de Boer Michiel C. Warlé |
| author_facet | Kim I. Albers Fatih Polat Ivo F. Panhuizen Marc M. J. Snoeck Gert-Jan Scheffer Hans D. de Boer Michiel C. Warlé |
| author_sort | Kim I. Albers |
| collection | DOAJ |
| description | Abstract Background There is increasing evidence for the use of lower insufflation pressures during laparoscopic surgery. Deep neuromuscular blockade allows for a safe reduction in intra-abdominal pressure without compromising the quality of the surgical field. While there is considerable evidence to support superior surgical conditions during deep neuromuscular blockade, there is only a limited amount of studies investigating patient outcomes. Moreover, results are not always consistent between studies and vary between different types of laparoscopic surgery. This study will investigate the effect of low-pressure pneumoperitoneum facilitated by deep NMB on quality of recovery after laparoscopic colorectal surgery. Methods The RECOVER study is a multicenter double-blinded randomized controlled trial consisting of 204 patients who will be randomized in a 1:1 fashion to group A, low-pressure pneumoperitoneum (8 mmHg) facilitated by deep neuromuscular blockade (post tetanic count of 1–2), or group B, normal-pressure pneumoperitoneum (12 mmHg) with moderate neuromuscular blockade (train-of-four response of 1–2). The primary outcome is quality of recovery on postoperative day 1, quantified by the Quality of Recovery-40 questionnaire. Discussion Few studies have investigated the effect of lower insufflation pressures facilitated by deep neuromuscular blockade on patient outcomes after laparoscopic colorectal procedures. This study will identify whether low pressure pneumoperitoneum and deep neuromuscular blockade will enhance recovery after colorectal laparoscopic surgery and, moreover, if this could be a valuable addition to the Enhanced Recovery After Surgery guidelines. Trial registration EudraCT 2018-001485-42 . Registered on April 9, 2018. Clinicaltrials.gov NCT03608436 . Registered on July 30, 2018. |
| first_indexed | 2024-12-10T14:33:15Z |
| format | Article |
| id | doaj.art-3a320fd3b26e43ea9fc421a089039348 |
| institution | Directory Open Access Journal |
| issn | 1745-6215 |
| language | English |
| last_indexed | 2024-12-10T14:33:15Z |
| publishDate | 2020-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Trials |
| spelling | doaj.art-3a320fd3b26e43ea9fc421a0890393482022-12-22T01:44:54ZengBMCTrials1745-62152020-06-012111810.1186/s13063-020-04496-8The effect of low- versus normal-pressure pneumoperitoneum during laparoscopic colorectal surgery on the early quality of recovery with perioperative care according to the enhanced recovery principles (RECOVER): study protocol for a randomized controlled studyKim I. Albers0Fatih Polat1Ivo F. Panhuizen2Marc M. J. Snoeck3Gert-Jan Scheffer4Hans D. de Boer5Michiel C. Warlé6Department of Surgery and Anesthesiology, Radboud University Medical CenterDepartment of Surgery, Canisius Wilhelmina HospitalDepartment of Anesthesiology, Canisius Wilhelmina HospitalDepartment of Anesthesiology, Canisius Wilhelmina HospitalDepartment of Anesthesiology, Radboud University Medical CenterDepartment of Anesthesiology, Martini General HospitalDepartment of Surgery, Radboud University Medical CenterAbstract Background There is increasing evidence for the use of lower insufflation pressures during laparoscopic surgery. Deep neuromuscular blockade allows for a safe reduction in intra-abdominal pressure without compromising the quality of the surgical field. While there is considerable evidence to support superior surgical conditions during deep neuromuscular blockade, there is only a limited amount of studies investigating patient outcomes. Moreover, results are not always consistent between studies and vary between different types of laparoscopic surgery. This study will investigate the effect of low-pressure pneumoperitoneum facilitated by deep NMB on quality of recovery after laparoscopic colorectal surgery. Methods The RECOVER study is a multicenter double-blinded randomized controlled trial consisting of 204 patients who will be randomized in a 1:1 fashion to group A, low-pressure pneumoperitoneum (8 mmHg) facilitated by deep neuromuscular blockade (post tetanic count of 1–2), or group B, normal-pressure pneumoperitoneum (12 mmHg) with moderate neuromuscular blockade (train-of-four response of 1–2). The primary outcome is quality of recovery on postoperative day 1, quantified by the Quality of Recovery-40 questionnaire. Discussion Few studies have investigated the effect of lower insufflation pressures facilitated by deep neuromuscular blockade on patient outcomes after laparoscopic colorectal procedures. This study will identify whether low pressure pneumoperitoneum and deep neuromuscular blockade will enhance recovery after colorectal laparoscopic surgery and, moreover, if this could be a valuable addition to the Enhanced Recovery After Surgery guidelines. Trial registration EudraCT 2018-001485-42 . Registered on April 9, 2018. Clinicaltrials.gov NCT03608436 . Registered on July 30, 2018.http://link.springer.com/article/10.1186/s13063-020-04496-8PneumoperitoneumIntra-abdominal pressureDeep neuromuscular blockLaparoscopyColorectalLaparoscopic surgery |
| spellingShingle | Kim I. Albers Fatih Polat Ivo F. Panhuizen Marc M. J. Snoeck Gert-Jan Scheffer Hans D. de Boer Michiel C. Warlé The effect of low- versus normal-pressure pneumoperitoneum during laparoscopic colorectal surgery on the early quality of recovery with perioperative care according to the enhanced recovery principles (RECOVER): study protocol for a randomized controlled study Trials Pneumoperitoneum Intra-abdominal pressure Deep neuromuscular block Laparoscopy Colorectal Laparoscopic surgery |
| title | The effect of low- versus normal-pressure pneumoperitoneum during laparoscopic colorectal surgery on the early quality of recovery with perioperative care according to the enhanced recovery principles (RECOVER): study protocol for a randomized controlled study |
| title_full | The effect of low- versus normal-pressure pneumoperitoneum during laparoscopic colorectal surgery on the early quality of recovery with perioperative care according to the enhanced recovery principles (RECOVER): study protocol for a randomized controlled study |
| title_fullStr | The effect of low- versus normal-pressure pneumoperitoneum during laparoscopic colorectal surgery on the early quality of recovery with perioperative care according to the enhanced recovery principles (RECOVER): study protocol for a randomized controlled study |
| title_full_unstemmed | The effect of low- versus normal-pressure pneumoperitoneum during laparoscopic colorectal surgery on the early quality of recovery with perioperative care according to the enhanced recovery principles (RECOVER): study protocol for a randomized controlled study |
| title_short | The effect of low- versus normal-pressure pneumoperitoneum during laparoscopic colorectal surgery on the early quality of recovery with perioperative care according to the enhanced recovery principles (RECOVER): study protocol for a randomized controlled study |
| title_sort | effect of low versus normal pressure pneumoperitoneum during laparoscopic colorectal surgery on the early quality of recovery with perioperative care according to the enhanced recovery principles recover study protocol for a randomized controlled study |
| topic | Pneumoperitoneum Intra-abdominal pressure Deep neuromuscular block Laparoscopy Colorectal Laparoscopic surgery |
| url | http://link.springer.com/article/10.1186/s13063-020-04496-8 |
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