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1.Screening
1.2.Inclusion Criteria

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

II

Age

30 year

Body Surface Area

31.2 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

30 year

Height

165 cm

Weight

85.0 kg

Lean body weight

48.1 kg

Ideal body weight

56.5 kg

Body Mass Index

31.2 kg/m2

Waistline

98 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

1.15 5.33 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

250 ug

Rocuronium total dose

65 mg

Remifentanil dose

1505 μg

Bispectral index of the EEG

36.3

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

5/5/4

Intra-abdominal pressure

13.8 mmHg

Duration of surgery

120 min

Mean arterial pressure

96.6 mmHg

Mean Heart rate

78.0 min-1

Compound sodium chloride

1000 ml

Bleeding

20 ml

Time to TOF=0.9

34 min

4.postoperation
4.1.Health Relative Quality of Life

SpO2<95% in the PACU

Duratin in the PACU

75 min

Time to out of bed

215 min

Time to gas passage

1355 min

Antiemetic

0 mg

Analgesic

0 mg

Post-Op complication

Hospital stay

119 h

Expenses of hospitalization

32048.16 yuan

4.2.follow-up 2

Shoulder pain

no

4.4.2.4.21、Diaphragm excursion

Diaphragm excursion

1.15 3.36 1.62 5.45 1.69 5.52 cm

4.4.2.4.22、QoR-15 score

Quality of Recovery Scores

29+13+20+17+24=103 35+17+20+20+31=123

4.4.2.4.23、VAS

Incision pain at rest

0/1.0/0

Incision pain at movement

3.0/0

Visceral pain at rest

3.0/4.0/1.0

Visceral pain at movement

4.0/2.0

4.4.2.4.24、Nausea and vomiting score

Postoperative nausea and vomiting grading

II