The Muscle Relaxing Effect Of Rocuronium On Laparoscopic Total Hysterectomy By Total Intravenous Anesthesia Or Combined Intravenous-Inhalational Anesthesia

Objective: To compare the effect,duration and safety of rocuronium between total intravenous anesthesia and combined intravenous-inhalational anesthesia.Methods: A total of 60 patients who underwent laparoscopic total hysterectomy in Shengjing Hospital of China Medical University were selected from 2022.01.01～2022.11.30.They were randomly divided into total intravenous anesthesia group(group A)and combined intravenous-inhalational anesthesia group(group B),with 30 cases in each group.Both groups were induced with 0.4μg/kg sufentanil,2mg/kg propofol and0.6mg/kg rocuronium.Maintenance: Group A: Propofol and remifentanil,Group B:sevoflurane and remifentanil,intraoperative BIS maintained at 40～60.Muscle relaxation monitoring instrument was used in both groups for muscle relaxation monitoring,hand temperature ≥32℃ was maintained,and relevant data were recorded:(1)Age,weight,BMI and other general information of patients in both groups.(2)Adductor pollicis(thumb)activity was assessed using a four-column(TOF)sequence and duration of TOF-count=0 was recorded in both groups,total rocuronium use in both groups,and pre-extubation TOF in both groups.(3)Surgical grade scale(SRS)scoring was performed at the following points: pneumoperitoneum establishment(T0),cervix dissociation(T1),uterine artery clipping(T2),and vaginal stump suturing(T3).(4)Operation time and pneumoperitoneum pressure were recorded in the two groups.(5)Intraoperative complications were recorded in the two groups.(6)Postoperative complications were recorded in the two groups.Results: The general data of the two groups showed no statistical difference(P>0.05).The duration of TOF-count=0 in group B was 35.00±3.79 minutes,and the duration of TOFcount=0 in group A was 24.07±3.18 minutes.The duration of TOF-count=0 in group B was longer than that in group A,with statistical significance(P<0.05).The total usage of rocuronium in group B was 52.33±7.28 mg,and that in group A was 56.83±9.14 mg.The total dosage of rocuronium in group B was significantly lower than that in group A,and the difference was statistically significant(P<0.05).The TOF of group B before extubation was higher than that of group A,with statistical significance(P<0.05).Compared with group A,SRS scores in group B were higher at T1,T2 and T3,and the difference was statistically significant(P<0.05).There were no significant differences in operation time and pneumoperitoneum pressure between the two groups,and no significant differences in intraoperative and postoperative complications between the two groups(P>0.05).Conclusions: Compared with the total intravenous anesthesia group,the combined intravenous-inhalational anesthesia group had longer duration of deep neuromuscular block,smaller total amount of rocuronium used,better surgical field of view and lower incidence of postoperative residual nerve block.