Background：Residual neuromuscular blockade is common in patients after general anesthesia, but few anesthesiologists use neuromuscular monitoring. In order to reduce the incidence of residual neuromuscular blockade and find a safer time for extubation, the purpose of our study is to explore the use of a simple measure of grip strength to roughly assess the recovery degree of neuromuscular blockade. Methods: Seventy-six patients undergoing elective general anaesthesia from November 2021 to June 2022, aged 18-70 years, with ASA classification of grade I-II were selected. A random number table method was used to divide into rocuronium and cis-atracurium groups. Patients' gender, age, BMI, ASA classification, total duration of surgery, PACU stay, preoperative basal grip strength values were recorded using a simple grip strength device, while the corresponding grip strength values at train-of-four (TOF) ration of 70%, 80% and 90% were monitored using a neuromuscular monitor. Spearman's correlation analysis was used to analyse the correlation between grip strength values and neuromuscular monitor values to determine whether the simple grip device could be used as a crude assessment of the degree of neuromuscular blockade recovery. Results: There was a significant correlation between grip strength values measured by the simple grip strength device and TOF ration during the patients' recovery from general anaesthesia (R2 =0.632). There was no significant difference in mean maximum grip strength recovery values between patients using rocuronium and those using cis-atracurium at the same TOF ration (p>0.05), and there was no significant difference in the total time of surgery (p=0.489) and total time spent in the PACU (p=0.202) between the two groups. There was a significant difference in preoperative basal grip strength values by gender (p<0.001), but there was no significant difference in mean maximum grip strength recovery at 70%, 80% and 90% of TOF ration and total time spent in the PACU (p>0.05). Conclusions: In this study, we developed a significant correlation between this simple grip strength device measurement and TOF ration from quantitative neuromuscular monitoring, which can be used as an additional strategy to roughly estimate the degree of myosin recovery, further improvements in grip strength measurement are needed.

There are different results on the effect of endotracheal tube (ETT) size on respiratory mechanics in patients undergoing mechanical ventilation, and there are few reports in adult laparoscopic surgery. The aim of this study was to investigate the effect of ETT size on airway resistance (RAW) and dynamic lung compliance (COMPL) in patients undergoing laparoscopic colorectal surgery. Seventytwo patients undergoing laparoscopic radical surgery for colorectal cancer under general anesthesia with endotracheal intubation were selected and divided into 3 groups (n = 24) using the random number table method Group A (ETT ID 7.0), Group B (ETT ID 7.5), and Group C (ETT ID 8.0). After mechanical ventilation, intraoperative RAW and COMPL were monitored in each of the 3 groups. In the non-pneumoperitoneal state, RAW in group ID7.0 is significantly higher than this in group ID7.5 and group ID8.0 (P < .05); the RAW between the 2 groups with ID7.5 and ID8.0 was not statistically significant (P > .05). The difference of COMPL between the 3 groups was statistically significant (P < .05); the COMPL of Group ID7.0 is lower than Group ID7.5, and Group ID7.5 is lower than Group ID8.0. In the pneumoperitoneal state, the RAW between ID7.0 group and ID8.0 group was statistically significant, the RAW difference between ID7.0 group and ID7.5 group, ID7.5 group and ID8.0 group not statistically significant (P > .05);the COMPL between the 3 groups was not statistically significant (P > .05). In the non-pneumoperitoneal state, the smaller the ETT internal diameter within a certain range, the higher RAW and the lower COMPL; in the pneumoperitoneal state, the RAW with the ID7.0 ETT was higher than that with the ID8.0 ETT, and the ETT size within a certain range had no effect on COMPL.