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1.Screening
1.2.Inclusion Criteria

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

II

Age

32 year

Body Surface Area

29.0 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

32 year

Height

158 cm

Weight

72.5 kg

Lean body weight

42.4 kg

Ideal body weight

50.1 kg

Body Mass Index

29.0 kg/m2

Waistline

105 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

1.28 2.34 cm

2.2.4.2.42、QoR-15 score

Quality of Recovery Scores

35+20+16+20+29=120

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

fentanyl

200 ug

Rocuronium total dose

90 mg

Remifentanil dose

1100 μg

Bispectral index of the EEG

44.7

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

13.0 mmHg

Duration of surgery

118 min

Mean arterial pressure

75.5 mmHg

Mean Heart rate

89.6 min-1

Compound sodium chloride

1000 ml

Bleeding

15 ml

Time to TOF=0.9

53 min

4.postoperation
4.1.Health Relative Quality of Life

SpO2<95% in the PACU

Duratin in the PACU

60 min

Time to out of bed

337 min

Time to gas passage

1357 min

Antiemetic

0 mg

Analgesic

100 mg

Post-Op complication

Hospital stay

113 h

Expenses of hospitalization

31841.89 yuan

4.2.follow-up 2

Shoulder pain

no

4.4.2.4.21、Diaphragm excursion

Diaphragm excursion

1.15 1.88 1.12 1.54 1.21 1.89 cm

4.4.2.4.22、QoR-15 score

Quality of Recovery Scores

28+20+17+18+31=114 48+18+20+20+36=142

4.4.2.4.23、VAS

Incision pain at rest

0/0/0

Incision pain at movement

1.0/1.0

Visceral pain at rest

2.0/4.0/0

Visceral pain at movement

6.0/1.0

4.4.2.4.24、Nausea and vomiting score

Postoperative nausea and vomiting grading

0