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1.Screening
1.2.Inclusion Criteria

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

III

Age

35 year

Body Surface Area

42.5 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

168 cm

Weight

120 kg

Lean body weight

58.1 kg

Ideal body weight

59.2 kg

Body Mass Index

42.5 kg/m2

Waistline

132 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

1.73 3.97 cm

2.2.4.2.42、QoR-15 score

Quality of Recovery Scores

37+20+20+20+35=132

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

fentanyl

100 ug

Rocuronium total dose

100 mg

Remifentanil dose

1320 μg

Bispectral index of the EEG

41.3

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

5/5/5

Intra-abdominal pressure

14.0 mmHg

Duration of surgery

137 min

Mean arterial pressure

79.9 mmHg

Mean Heart rate

80.9 min-1

Compound sodium chloride

1000 ml

Bleeding

20 ml

Time to TOF=0.9

37 min

4.postoperation
4.1.Health Relative Quality of Life

SpO2<95% in the PACU

Duratin in the PACU

120 min

Time to out of bed

65 min

Time to gas passage

2705 min

Antiemetic

12 mg

Analgesic

275 mg

Post-Op complication

Hospital stay

120 h

Expenses of hospitalization

43298.69 yuan

4.2.follow-up 2

Shoulder pain

no

4.4.2.4.21、Diaphragm excursion

Diaphragm excursion

1.07 2.08 1.54 3.07 1.34 3.54 cm

4.4.2.4.22、QoR-15 score

Quality of Recovery Scores

31+0+17+17+31=96 40+18+20+20+38=136

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

3.0/2.0/0

Visceral pain at movement

5.0/2.0

4.4.2.4.24、Nausea and vomiting score

Postoperative nausea and vomiting grading

III