To analyze the effects of different cis-atracurium regimens on postoperative recovery, stress and early recovery quality of patients undergoing laparoscopic gastrectomy.

A total of 80 patients who were treated by laparoscopic gastrectomy in General Hospital of Huainan East Hospital Group from January 2021 to June 2023 were selected randomly divided into intermittent infusion group (n=40) and continuous infusion group (n=40). Both groups adopted the same anesthesia induction scheme. The intermittent infusion group was given 0.03 mg/kg cis-atracurium whenever T1 recovered to 10% during operation, and in the continuous infusion group, 1.4 μg/(kg·min) continuous intravenous infusion of cis-atracurium was initiated when T1 recovered to 10% at the first time. The maintenance and recovery of muscle relaxation during operation, the quality of postoperative recovery and the changes of perioperative stress indexes were compared between the two groups, and the early rehabilitation quality of the two groups was evaluated by the first postoperative exhaust time and gastrointestinal function recovery time.

The recovery time of TOF to 75%, recovery index, total dosage and average administration speed in the intermittent infusion group were higher than those in the continuous infusion group (P<0.05). The recovery time of spontaneous respiration and extubation time in the intermittent infusion group were longer than those in the continuous infusion group (P<0.05). The levels of epinephrine (E), norepinephrine (NE) and cortisol (Cor) in both groups were higher immediately after pneumoperitoneum, 30 min after pneumoperitoneum and at the end of operation compared with before anesthesia induction (P<0.05). At the same time, there was no statistically significant difference in stress indexes between the two groups (P>0.05). The recovery time of gastrointestinal function in the intermittent infusion group was longer than that in the continuous infusion group (P<0.05). The incidence of postoperative adverse reactions in the intermittent infusion group was higher than that in the continuous infusion group (P<0.05).

Compared with intermittent infusion, continuous infusion of cis-atracurium can promote postoperative muscle relaxation recovery and recovery, improve the quality of early recovery and reduce the risk of adverse reactions without affecting the anesthetic effect and aggravating stress response.