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However, controversy remains about the required depth of neuromuscular block (NMB) needed for optimal surgical working conditions and how this relates to other outcomes. For instance, a deep neuromuscular block yields superior surgical working conditions compared to a standard NMB in laparoscopic surgery, however, a robust association to other (safety) outcomes has not yet been established.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Trial design: an international multicenter randomized controlled double-blind strategy trial.<\/jats:p>\n                    <jats:p>Trial population: 922 patients planned for elective, laparoscopic or robotic, abdominal surgery.<\/jats:p>\n                    <jats:p>Intervention: Patients will be randomized to a deep NMB (post-tetanic count 1\u20132 twitches) or standard care (single-dose muscle relaxant administration at induction and repeated only if warranted by surgical team).<\/jats:p>\n                    <jats:p>Main trial endpoints: Primary endpoint is the difference in incidence of intraoperative adverse events during laparoscopic surgery graded according to ClassIntra\u00ae classification (i.e., ClassIntra\u00ae grade \u2265 2) between both groups. Secondary endpoints include the surgical working conditions, 30-day postoperative complications, and patients\u2019 quality of recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This trial was designed to analyze the effect of deep neuromuscular block compared to standard neuromuscular block on intra- and postoperative adverse events in patients undergoing laparoscopic surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      ClinicalTrials.gov\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04124757\">NCT04124757<\/jats:ext-link>\n                      (EURO-RELAX); registration URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04124757\">https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04124757<\/jats:ext-link>\n                      , registered on\u00a0October 11th, 2019.\u00a0\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13063-021-05638-2","type":"journal-article","created":{"date-parts":[[2021,10,26]],"date-time":"2021-10-26T07:03:22Z","timestamp":1635231802000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["The impact of deep versus standard neuromuscular block on intraoperative safety during laparoscopic surgery: an international multicenter randomized controlled double-blind strategy trial \u2014 EURO-RELAX TRIAL"],"prefix":"10.1186","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9747-6966","authenticated-orcid":false,"given":"Maarten","family":"Honing","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabby","family":"Reijnders-Boerboom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salome","family":"Dell-Kuster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monique","family":"van Velzen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Martini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco","family":"Valenza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Proto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar D\u00edaz","family":"Cambronero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Broens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivo","family":"Panhuizen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margot","family":"Roozekrans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Fuchs-Buder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martijn","family":"Boon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Dahan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel","family":"Warl\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,10,26]]},"reference":[{"issue":"3","key":"5638_CR1","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1007\/s00464-014-3711-7","volume":"29","author":"M Blobner","year":"2015","unstructured":"Blobner M, Frick CG, Stauble RB, Feussner H, Schaller SJ, Unterbuchner C, et al. 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