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1.Screening
1.2.Inclusion Criteria

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

III

Age

37 year

Body Surface Area

40.9 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

37 year

Height

154 cm

Weight

97 kg

Lean body weight

47.9 kg

Ideal body weight

46.5 kg

Body Mass Index

40.9 kg/m2

Waistline

122 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

1.03 2.47 cm

2.2.4.2.42、QoR-15 score

Quality of Recovery Scores

40+20+20+20+35=135

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

fentanyl

186 ug

Rocuronium total dose

130 mg

Remifentanil dose

1260 μg

Bispectral index of the EEG

40.7

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

120 min

Mean arterial pressure

84.0 mmHg

Mean Heart rate

76.6 min-1

Compound sodium chloride

1300 ml

Bleeding

20 ml

Time to TOF=0.9

47 min

4.postoperation
4.1.Health Relative Quality of Life

SpO2<95% in the PACU

Duratin in the PACU

80 min

Time to out of bed

280 min

Time to gas passage

1990 min

Antiemetic

0 mg

Analgesic

0 mg

Post-Op complication

Hospital stay

167 h

Expenses of hospitalization

48536.6 yuan

4.2.follow-up 2

Shoulder pain

no

4.4.2.4.21、Diaphragm excursion

Diaphragm excursion

1.08 2.1 1.04 2.16 1.16 4.04 cm

4.4.2.4.22、QoR-15 score

Quality of Recovery Scores

28+10+20+15+26=99 42+16+20+20+24=122

4.4.2.4.23、VAS

Incision pain at rest

0/1.0/0

Incision pain at movement

2.0/1.0

Visceral pain at rest

3.0/2.0/1.0

Visceral pain at movement

3.0/2.0

4.4.2.4.24、Nausea and vomiting score

Postoperative nausea and vomiting grading

I