Rocuronium

General anaesthesia was induced and maintained by total intravenous technique (TIVA) with target controlled infusion (TCI - Alaris, PK CareFusion, Sarl, Switzerland) of propofol 2–6µg/ml according to Marsh pharmacokinetic model (Propofol Sandoz®, Sandoz, Copenhagen, Denmark) and remifentanil 2-10ng/ml according to Minto pharmacokinetic model (Ultiva®, GlaxoSmithKline,Solna, Sweden) with muscle relaxation achieved by Rocuronium 0,6 mg/kg during induction of anaesthesia, followed by incremental doses of 0,15mg/kg during surgery (Rocuronium, Fresenius Kabi, Uppsala, Sweden).

In the operating room, general anesthesia is induced with 2 to 3 mg·kg^-1 propofol (Fresenius Kabi, Zeist, the Netherlands), sufentanil (Bipharma, Almere, the Netherlands) for analgesia and 0.6 mg·kg^-1 rocuronium (Fresenius Kabi, Zeist, the Netherlands) for paralysis. The trachea is intubated, and the lungs are mechanically ventilated with pressure regulated volume control. After induction, general anesthesia is maintained with sevoflurane (AbbVie, Hoofddorp, the Netherlands) at a minimal alveolar concentration (MAC) of 1 and, when needed (based on signs of pain), is supplemented by an additional bolus of sufentanil. An arterial line is inserted into the right or left radial artery. A right jugular tri-lumen central line is inserted when deemed necessary. A double lumen gastric cannula is inserted. A urinary catheter is inserted. Cefazoline (Kefzol™) 2 g and metronidazol (Flagyl™) 500 mg are given prior to incision. Cefazoline is repeated after 6 h if the surgery is ongoing.