Anesthetic management
tachycardia
LOCAL INFILTRATION, NEUROMUSCULAR BLOCKADE, HEART, HYPERTENSION, PNEUMOPERITONEUM
The anesthesia and surgical procedure will be consistent between the two groups. In the operating room, the patient received an intravenous fluid replacement and mask oxygen. Then, vital signs and depth of anesthesia were monitored, and baseline values were measured before anesthesia. General anesthesia was induced with midazolam 0.03-0.04 mg/kg, etomidate 0.2–0.3 mg/kg, sufentanil 0.3–0.5 μg/kg, and cisatracurium 0.15-0.2 mg/kg. After tracheal intubation, Group E received different doses of esketamine through intravenous administration, and Group C received the same quantity of saline at the same time. The anesthesia was maintained with propofol 4–6 mg/(kg·h), sevoflurane 1-1.5%, remifentanil 0.2–0.3 μg/(kg·min), and cisatracurium 0.1-0.15 mg/kg/h. Sevoflurane and cisatracurium were no longer used during skin incision suturing. Inadequate anesthesia was defined as patient movement, swallowing, lacrimation, sweating, hypertension, and tachycardia (more than 20% above baseline values for at least 1 min), and the bispectral index (BIS) score greater than 60. When the depth of anesthesia was considered insufficient, the propofol, remifentanil and sevoflurane infusion/intake rates were changed in steps of 1 mg/(kg·h), 0.05 μg/(kg·min) and 0.5%, respectively. BP and HR were stabilized between ± 20% of baseline. Parecoxib 40 mg was administered when pneumoperitoneum was stopped, and 0.5% ropivacaine was applied to the incision for local infiltration anesthesia.Atropine and esmolol were routinely administered to regulate Heart rate (HR), and dopamine and urapidil were used for maintaining blood pressure stability conventionally. All anesthetics were discontinued after the operation, and then the patients were transferred to the postanesthetic care unit (PACU). If the TOF ratios were 1.0, residual neuromuscular blockade was antagonized with neostigmine 0.02 mg/kg together with atropine 0.01 mg/kg, and the dosages of drugs were adjusted based on the patient’s actual conditions. The patients were extubated after surgery when they met the extubation indications.