Anesthetic procedure
PONV, postoperative nausea or vomiting
Before their surgeries, all of the participants regularly fasted and did not take any premeds. A variety of routine monitoring procedures were used, including electrocardiography (ECG), noninvasive blood pressure (NBP), peripheral pulse oximetry (SpO2), airway pressure monitoring, capnography, Narcotrend (MT MonitorTechnik GnbH & Co.KG, Narcotrend-Compact) and muscle relaxant monitor (GE Healthcare Finland Oy, SJC15300045HA). The heart rate (HR), systolic pressure (SBP), diastolic pressure (DBP) and mean arterial pressure (MAP) measured 10 minutes after the patients entered the room were taken as the base values. In both group, general anesthesia was induced using 0.04mg/kg midazolam, 1.5–2.5mg/kg propofol, 0.4ug/kg sufentanil and different dose of rocuronium.Patients randomized to the CON Group received rocuronium 0.6mg/kg and traditional endotracheal tube. However, those in the NEURO group had rocuronium 0.3mg/kg, after that, The attending anesthesiologist used a video-laryngoscope to position the Never Integrity Monitor (NIM) endotracheal tube (Medtronic, USA) on the patient. The correct position of the NIM endotracheal tube was confirmed using both capnography and the IONM’s dedicated signal quality checking system.Intravenous compound general anesthesia was used to treat the patients in both groups. During surgery, anesthesia was maintained with desflurane of a Minimal Alveolar Concentration (MAC) of 0.7–0.9 and with propofol through Target Controlled Infusion (TCI) at 1.0μg/ml. Level of sedation was monitored with Narcotrend and sedatives targeted to a Narcotrend value around 37–64. Intro-operative analgesia was guaranteed by continuous infusion of remifentanil at 0.05–0.1μg/(kg·min). No additional rocuronium was added to the patients in the NEURO Group during the operation, while in the CON Group, 1/3 induction dose of rocuronium was added when the TOF = 2.If the mean arterial pressure (MAP) of the patient during anesthesia is less than 55 mmHg or its reduction exceeds the base value by more than 20%, intravenous injection of ephedrine 5 mg was given, and the infusion speed of remifentanil was slowed down or the concentration of desflurane was reduced as appropriate; If the mean arterial pressure (MAP) during anesthesia is higher than 110mmHg or exceeds the base value by more than 20%, 5μg sufentanil is injected intravenously; If the heart rate of the patient is less than 50 beats/minute, atropine 0.5mg shall be injected intravenously. 0.25mg palonosetron for participants to prevents postoperative nausea or vomiting (PONV) and 50mg flurbiprofen axetil was provided at the end of the surgery for postoperative analgesia.