Hemodynamic and Respiratory Variations During Laparoscopic Surgery With and Without Deep Neuromuscular Blockade.

A Prospective, Double-blind, Randomized, Crossover Design Study to Compare the Hemodynamic and Respiratory Variations During Laparoscopic Surgery in Patients With and Without Deep Neuromuscular Blockade.

The goal of this study is to investigate the effect of depth of neuromuscular block (NMB) on global and regional (dependent versus nondependent) respiratory mechanics during laparoscopic surgery. Furthermore, we will investigate if the level of NMB influences intraoperative hemodynamic and cerebral oxygenation.

Inclusion Criteria:

• Age 18 years or older
• Elective patients scheduled to undergo laparoscopic surgery with expected duration > 2h
• Physical status ASA I - III

Exclusion Criteria:

• Pregnancy
• Severe cardiac disease (NYHA class III or IV, acute coronary syndrome, or persistent ventricular tachyarrhythmia)
• Previous lung surgery
• History of severe chronic obstructive pulmonary disease
• Gastro-esophageal pathology (including but not limited to recent gastric or esophageal surgery including bypass/banding, history of esophageal varices, known anatomical gastric or esophageal defects such as strictures, hernias or fistulas)
• Mechanical ventilation within the last 30 days
• Neuromuscular disease
• Consented for another interventional study or refusal to participate in the present study
• Hypersensitivity (e.g., anaphylaxis) to rocuronium bromide or other neuromuscular blocking agents