Muscle Relax Affects Outcomes of Robotic Surgery (MORE)

During robotic laparoscopic surgery, a high intraperitoneal pressure may result in high airway pressure and inadequate perfusion of the abdominal organs, and as a result the postoperative outcomes. Degree of neuromuscular blockade (NMB) can affect the intraperitoneal pressure. In this study, the patients undergoing robotic laparoscopic surgery will be assigned to deep NMB group and moderate NMB group. Perioperative outcomes including maximal intraperitoneal pressure, maximal intraoptic pressure, quality of emergence, postoperative pain, and incidence of postoperative respiratory complication will be compared. The results of this study will provide evidence for optimizing NMB protocol of robotic laparoscopic surgery.

Muscle relaxant will be given by a specific investigator that is not involved in anesthesia and outcome assessment

Rocuronium, a neuromuscular blocking agent will be given by continuous infusion at a dose that reaction to train of four (TOF) stimulation is depressed to zero

Rocuronium, a neuromuscular blocking agent will be given at a dose by intermittent injection that reaction to train of four (TOF) stimulation is kept 1 to 2

airway pressure is titrated to as low as possible as long as the end tidal carbon dioxide partial pressure is lower than 40 mmHg

criteria of extubation: spontaneous respiratory rate>10 per minute and end tidal carbon dioxide partial pressure<45mmHg

from admittance to post-anesthesia care unit(PACU) to discharge from PACU, at an average of 30 minutes

from admittance to post-anesthesia care unit(PACU) to discharge from PACU, at an average of 30 minutes

the patient is asked to give a score between 0 and 10, 0 means not satisfied,10 means totally satisfied.

Inclusion Criteria: patients scheduled for elective robotic laparoscopic surgery under general anesthesia American Society of Anesthesiologists status 1-2 Body mass index of 18-30kg/m2 Patients scheduled to be positioned in trendelenburg position during surgery Exclusion Criteria: Patients allergic to rocuronium Patients with neuromuscular dysfunction Patients with existed pulmonary diseases Patients with hepatic or renal dysfunction

After publishing, data of the primary endpoint and second endpoints can be shared with other researchers

When the results have been published in peer-reviewed journals, the data will be available. The planned time frame will be 5 years.

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