The goal of this clinical trial is to investigate the Impact of adding SIMV Synchronization to our standard PCV-VG mode of ventilation on muscle relaxant consumption, the frequency of relaxant top-ups and surgeon satisfaction during Laparoscopic Cholecystectomy surgeries in ASA I\&II. The main question it aims to answer is do Ventilator synchrony (PCV-VG+SIMV) reduces muscle relaxant consumption and improves surgeon satisfaction by minimizing the perception of inadequate paralysis?
Primary hypothesis: Ventilator synchrony (PCV-VG+SIMV) reduces muscle relaxant consumption and improves surgeon satisfaction by minimizing the perception of inadequate paralysis.
Primary outcome;
1. Compare total intraoperative rocuronium consumption (mg/kg) between PCV-VG and PCV-VG + SIMV 2. To determine the frequency of additional muscle relaxant requests
Adults aged 18-60 years undergoing elective laparoscopic cholecystectomy.
ASA (American Society of Anesthesiologists) physical status I-II
BMI 18-35 kg/m²
Severe COPD or restrictive lung disease
Neuromuscular disorders
Emergency surgery
Morbid obesity
Parallel
Non-Synchronized Group (Control)
Other interventionVentilation managed using PCV-VG mode of ventilation
Synchronized group
Other interventionVentilation managed using PCV-VG plus SIMV (a mixed mode that supports patient-ventilator synchrony)
Total intraoperative muscle relaxant consumption
Number of surgeon request to rocuronium top-up doses
Train of four (TOF) ratio
Peak airway pressure
every 15 minutes
Compliance
every 15 minutes
Delivered tidal volume
every 15 minutes
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Hitham Mohammed Aly Elsayed
Lead sponsor
Imam Abdulrahman Bin Faisal University
Sponsor institution
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