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1.Screening
1.2.Inclusion Criteria

American Society of Anesthesiologists (ASA) physical status I-III

II

Age

57 year

Body Surface Area

34.1 kg/m2

Scheduled to undergo sleeve gastrectomy

纳入

1.3.Exclusion Criteria

Neuromuscular disorders

Allergies to, or contraindication for muscle relaxants, neuromuscular reversing agents, nesthetics, narcotics

History of malignant hyperthermia

Pregnancy or lactation

Renal insufficiency

Chronic obstructive pulmonary disease GOLD classification 2 or higher

upper or lower airway infection

Congestive heart failure

Psychiatric illness inhibiting cooperation with study protocol or possibly obscuring results

Diaphragm with poor ultrasound visualization

2.base line
2.2.General information

Sex(male/female)

Age

57 year

Height

155 cm

Weight

82.0 kg

Lean body weight

44.4 kg

Ideal body weight

47.4 kg

Body Mass Index

34.1 kg/m2

Waistline

117 cm

Hypertension

mmHg

Diabetes

Dyslipidemia

2.3.Physical examination

Abdominal surgery history

Obstructive sleep apnea syndrome

2.4.follow-up 1
2.2.4.2.41、Diaphragm excursion

Diaphragm excursion

1.76 4.93 cm

2.2.4.2.42、QoR-15 score

Quality of Recovery Scores

50+20+20+20+40=150

3.In the process of the treatment
3.1.Treatment Record

fentanyl

200 ug

Rocuronium total dose

95 mg

Remifentanil dose

1230 μg

Bispectral index of the EEG

43.0

Frequency of rescue NMBA

0

Reported muscle movements

0

Entirely optimal (5) throughout pneumoperitoneum

Entirely good to optimal (4–5) throughout pneumoperitoneum

Surgical field condition score

5/5/5

Intra-abdominal pressure

11.0 mmHg

Duration of surgery

129 min

Mean arterial pressure

96.7 mmHg

Mean Heart rate

85.0 min-1

Compound sodium chloride

1000 ml

Bleeding

15 ml

Time to TOF=0.9

50 min

4.postoperation
4.1.Health Relative Quality of Life

SpO2<95% in the PACU

Duratin in the PACU

110 min

Time to out of bed

410 min

Time to gas passage

950 min

Antiemetic

0 mg

Analgesic

0 mg

Post-Op complication

Hospital stay

96 h

Expenses of hospitalization

31355.8 yuan

4.2.follow-up 2

Shoulder pain

no

4.4.2.4.21、Diaphragm excursion

Diaphragm excursion

1.31 3.02 2.34 4.11 1.48 4.13 cm

4.4.2.4.22、QoR-15 score

Quality of Recovery Scores

50+11+20+15+40=136 50+11+20+20+40=141

4.4.2.4.23、VAS

Incision pain at rest

1.0/1.0/1.0

Incision pain at movement

2.0/1.0

Visceral pain at rest

3.0/2.0/1.0

Visceral pain at movement

3.0/1.0

4.4.2.4.24、Nausea and vomiting score

Postoperative nausea and vomiting grading

0