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1.Screening
1.2.Inclusion Criteria

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

II

Age

35 year

Body Surface Area

32.0 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

35 year

Height

162 cm

Weight

84.0 kg

Lean body weight

46.9 kg

Ideal body weight

53.7 kg

Body Mass Index

32.0 kg/m2

Waistline

109 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 4.9 cm

2.2.4.2.42、QoR-15 score

Quality of Recovery Scores

48+20+20+20+38=146

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

fentanyl

225 ug

Rocuronium total dose

55 mg

Remifentanil dose

1195 μg

Bispectral index of the EEG

46.7

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

Intra-abdominal pressure

14.0 mmHg

Duration of surgery

90 min

Mean arterial pressure

82.0 mmHg

Mean Heart rate

68.4 min-1

Compound sodium chloride

1000 ml

Bleeding

15 ml

Time to TOF=0.9

55 min

4.postoperation
4.1.Health Relative Quality of Life

SpO2<95% in the PACU

Duratin in the PACU

50 min

Time to out of bed

595 min

Time to gas passage

3845 min

Antiemetic

0 mg

Analgesic

100 mg

Post-Op complication

术后贫血

Hospital stay

144 h

Expenses of hospitalization

33948.2 yuan

4.2.follow-up 2

Shoulder pain

no

4.4.2.4.21、Diaphragm excursion

Diaphragm excursion

1.43 3.53 1.43 3.99 1.48 3.05 cm

4.4.2.4.22、QoR-15 score

Quality of Recovery Scores

33+15+20+14+38=120 46+17+20+20+40=143

4.4.2.4.23、VAS

Incision pain at rest

0/1.0/0

Incision pain at movement

3.0/1.0

Visceral pain at rest

5.0/0/0

Visceral pain at movement

3.0/1.0

4.4.2.4.24、Nausea and vomiting score

Postoperative nausea and vomiting grading

0