This randomized controlled study aims to evaluate the effects of deep versus moderate neuromuscular blockade on intraoperative driving pressure and the development of postoperative critical respiratory events in patients undergoing abdominal surgery under general anesthesia.
Elective abdominal surgery under general anesthesia that is expected to last longer than one hour
ASA I-II-III
Age ≥18 years
Written informed consent
Refusal to participate in the study
ASA ≥ IV
Age <18
Obesity (BMI>30) and cachexia (BMI <18)
Parallel
Rocuronium
DrugRocuronium will be administered intravenously as bolus and continuous infusion to achieve target neuromuscular blockade depth according to group allocation. Neuromuscular function will be monitored using quantitative TOF monitoring.
Mean Intraoperative Driving Pressure
Driving pressure will be calculated as plateau pressure minus positive end-expiratory pressure (PEEP) during volume-controlled ventilation. Measurements will be recorded at 30-minute intervals throughout surgery, and the mean value per patient will be calculated.
Incidende of Postoperative Critical Respiratory Events
Critical respiratory events (CRE) include hypoxemia (hemoglobin oxygen saturation \< 90%), hypoventilation (respiratory rate \< 8 breaths/min or arterial carbon dioxide tension \> 50 mmHg) or upper-airway obstruction (stridor or laryngospasm) requiring an active and specific intervention (ventilation, tracheal intubation, opioid or muscle relaxant antagonism, insertion of oral/nasal airway or airway manipulation).
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This trial is not recruiting at the moment. You can still explore other options:
