{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T19:41:09Z","timestamp":1780774869832,"version":"3.54.1"},"reference-count":68,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T00:00:00Z","timestamp":1673308800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To determine the safety and efficacy of deep neuromuscular block (NMB) for endolaryngeal surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources<\/jats:title><jats:p>PubMed, Web of Science, Cochrane Library, Ovid Medline, Embase, China National Knowledge Infrastructure, Wanfang, VIP databases, and trial registry database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Inclusion criteria followed the PICOS principles: Participants, adults undergoing endolaryngeal surgery; Intervention, deep NMB performed during the surgery; Control, no\u2010deep NMB performed; Outcomes, primary outcome: the incidence of clinically acceptable surgical conditions. Secondary outcome: the incidence of intraoperative complications (including vocal fold movement and coughing) and total incidence of postoperative complications [including postoperative residual curarization (PORC), postoperative sore throat (POST), and postoperative nausea and vomiting (PONV)]. Study design, randomized controlled trials (RCTs). Duplicate publications, editorials, letters, abstracts, and reviews were excluded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four articles with 242 patients were identified for analysis. The results indicated that compared with no\u2010deep NMB, deep NMB provides a higher incidence of clinically acceptable surgical conditions (98.36% vs. 76.67%; relative ratio [RR]\u00a0=\u00a01.29, 95% CI: 1.07\u20131.56), a lower incidence of intraoperative complications (10.83% versus 37.16%; RR\u00a0=\u00a00.32; 95% CI: 0.21\u20130.49) (lower incidence of vocal fold movement [1.85% vs. 34%; RR\u00a0=\u00a00.08, 95% CI: 0.02\u20130.41] and coughing [15.53% vs. 38.78%; RR\u00a0=\u00a00.42, 95% CI: 0.27\u20130.66]). There were no differences in the overall incidence of postoperative complications (RR\u00a0=\u00a02.10, 95% CI: 0.12\u201336.40).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Based on current published evidence, deep NMB provides better surgical conditions with a higher incidence of clinically acceptable surgical conditions and a lower incidence of intraoperative complications (lower incidence of vocal fold movement and coughing) without increasing the overall incidence of postoperative complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>1 <jats:italic>Laryngoscope<\/jats:italic>, 133:2055\u20132065, 2023<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30561","type":"journal-article","created":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T10:16:04Z","timestamp":1673345764000},"page":"2055-2065","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Deep Neuromuscular Block for Endolaryngeal Surgery: A Systematic Review and <scp>Meta\u2010Analysis<\/scp>"],"prefix":"10.1002","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8091-1837","authenticated-orcid":false,"given":"Jianqiao","family":"Zheng","sequence":"first","affiliation":[{"name":"Department of Anesthesiology West China Hospital, Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Sichuan Cancer Hospital &amp; Institute, Sichuan Cancer Center, School of Medicine University of Electronic Science and 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