Comparison of the Application Effects of Two Muscle Relaxation States in Laparoscopic Gastric Reduction Surgery for Patients with OSAS and Morbid Obesity
ZHAO Zhili
LIU Xu
ZHAO Jiping
ZHAO Wei
Abstract：Objective To investigate the effects of two muscle relaxation states on the operating space,anesthesia recovery,pulmonary function,and adverse reactions of laparoscopic gastric reduction surgery in morbid obese patients with obstructive sleep apnea syndrome(OSAS).Methods A retrospective study was conducted on 80 patients with morbid obesity accompanied by OSAS who underwent laparoscopic gastric reduction surgery at the First Affiliated Hospital of Xinxiang Medical College from August 2022 to May 2024.These patients were divided into an observation group(40 cases,deep muscle relaxation strategy)and a control group(40 cases,moderate muscle relaxation strategy)based on different muscle relaxation strategies.The study compared the muscle relaxation effects and recovery conditions between the two groups,the intraoperative operating space under different pneumoperitoneum pressures(12 mmHg and 8 mmHg),visual analogue scale(VAS)scores for shoulder pain at different time points(4,8,12,24 h after surgery),anesthesia recovery[extubation time,post-anesthesia care unit(PACU)stay time,first bowel movement time,postoperative hospital stay],oxygenation index(OI)and respiratory index(RI)at different time points(after intubation,10 min after pneumoperitoneum,and at the end of surgery),as well as adverse reactions.Results The satisfaction rate of muscle relaxation in the observation group was 95.00％,and the dose of muscle relaxant was(42.15±6.40)mg,both of which were higher than those in the control group[37.50％,(37.26±7.59)mg],and the differences were statistically significant(P＜0.05).The operating space of patients in the observation group was(6.87±0.30)cm and(5.90±0.28)cm at 12 mmHg and 8 mmHg of pneumoperitoneum,respectively,which were larger than those in the control group(6.32±0.41)cm and(5.53±0.34)cm,respectively,with statistically significant differences(P＜0.05).The VAS scores of shoulder pain in the observation group at 4 h,8 h,12 h,and 24 h after surgery were(2.15±0.66)scores,(2.67±0.75)scores,(2.80±0.71)scores,and(0.96±0.20)scores,respectively,which were lower than those in the control group at(2.83±0.78)scores,(3.20±0.62)scores,(3.35±0.59)scores,and(1.56±0.37)scores,respectively,and the differences were statistically significant(P＜0.05).The extubation time of patients in the observation group was(14.35±3.94)minutes,which was longer than that of the control group(12.10±4.15)minutes.The first exhaust time was(71.56±14.83)hours,which was shorter than that of the control group(83.66±12.91)hours,and the differences were statistically significant(P＜0.05).The OI of patients in the observation group was(479.91±35.35)mmHg and(472.58±25.74)mmHg at 10 minutes after pneumoperitoneum and at the end of surgery,respectively,while those in the control group were(480.16±32.00)mmHg and(475.68±28.50)mmHg,respectively,which were lower than those in the observation group after intubation(494.11±27.83)mmHg and those in the control group(490.87±30.14)mmHg,respectively,with statistically significant differences(P＜0.05).There was no significant difference in RI between the two groups at 10 minutes after pneumoperitoneum and at the end of surgery,as compared with that after intubation(P＞0.05).There was no significant difference in OI and RI between the observation group and the control group after intubation,10 minutes after pneumoperitoneum,and at the end of surgery(P＞0.05).The total incidence of adverse reactions in the observation group(5.00％)was not significantly different from that in the control group(10.00％)(P＞0.05).Conclusion Under general anesthesia,deep muscle relaxation can provide sufficient surgical space for morbidly obese patients with OSAS undergoing laparoscopic gastric reduction surgery,improve the satisfaction rate of muscle relaxation,reduce postoperative shoulder pain,and shorten the time of exhaust.Although the dose of muscle relaxant is large,the time of extubation is delayed,and there is no significant improvement in oxygenation,there is no significant increase in adverse reactions,and the safety is reliable.
Keywords：obstructive sleep apnea syndromemorbid obesitymuscle relaxation statelaparoscopic gastric reduction surgeryoperating spaceanesthesia recoverypulmonary function
Publication Date：2025-08-13
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：6( 2744-2749 )