The neuromuscular block state may affect the electroencephalogram-derived index representing the anesthetic depth. We applied an Anesthetic Depth Monitoring for Sedation (ADMS) to patients undergoing laparoscopic cholecystectomy under total intravenous anesthesia, and evaluated the requirement of propofol according to the different neuromuscular block state. Adult patients scheduled to undergo laparoscopic cholecystectomy were enrolled and randomly assigned to either the moderate (MB) or deep neuromuscular block (DB) group. The UniCon sensor of ADMS was applied to monitor anesthetic depth and the unicon value was maintained between 40 and 50 during the operation. According to the group assignment, intraoperative rocuronium was administered to maintain proper neuromuscular block state, moderate or deep block state. The unicon value, electromyography (EMG) index, and total dose of propofol and rocuronium were analyzed. At similar anesthetic depth, less propofol was used in the DB group compared to the MB group (6.19 ± 1.36 in the MB mg/kg/h group vs 4.93 ± 3.02 mg/kg/h in the DM group, p = 0.042). As expected, more rocuronium were used in the DB group than in the MB group (0.8 ± 0.2 mg/kg in the MB group vs 1.2 ± 0.2 mg/kg in the DB group, p = 0.023) and the EMG indices were lower in the DB group than in the MB group, at several time points as follows: at starting operation (p < 0.001); at 15 (p = 0.019), 45 (p = 0.011), and 60 min (p < 0.001) after the initiation of the operation; at the end of operation (p = 0.003); and at 5 min after the administration of sugammadex (p < 0.001). At similar anesthetic depth, patients under the deep neuromuscular block state required less propofol with lower intraoperative EMG indices compared to those under the moderate neuromuscular block state during general anesthesia.

神经肌肉阻滞状态可能影响代表麻醉深度的脑电图衍生指数。我们对全静脉麻醉下腹腔镜胆囊切除术的患者应用镇静麻醉深度监测（ADMS），并根据不同的神经肌肉阻滞状态评估异丙酚的需要量。计划接受腹腔镜胆囊切除术的成年患者被纳入并随机分配到中度（MB）组或深部神经肌肉阻滞（DB）组。采用ADMS的UniCon传感器监测麻醉深度，术中unicon值维持在40~50之间。根据分组，术中给予罗库溴铵以维持适当的神经肌肉阻滞状态、中度或深度阻滞状态。分析unicon值、肌电图（EMG）指数以及异丙酚和罗库溴铵的总剂量。在相似的麻醉深度下，与 MB 组相比，DB 组使用的异丙酚较少（MB 组为 6.19 ± 1.36 mg/kg/h，DM 组为 4.93 ± 3.02 mg/kg/h，p = 0.042 ）  。正如预期的那样，DB 组比 MB 组使用了更多的罗库溴铵（MB 组为 0.8 ± 0.2 mg/kg vs DB 组为 1.2 ± 0.2 mg/kg，p = 0.023），并且 EMG指数 较低在如下几个时间点，DB 组比 MB 组要高： 开始操作时 ( p  < 0.001)； 手术开始后15 分钟 ( p  = 0.019)、45 分钟 ( p  = 0.011) 和 60 分钟 ( p < 0.001)；操作结束时（p  = 0.003）；以及给予舒更葡糖后 5 分钟（p  < 0.001）。在相似的麻醉深度下，与全身麻醉中度神经肌肉阻滞状态下的患者相比，深度神经肌肉阻滞状态下的患者需要较少的丙泊酚，术中肌电图指数也较低。