Evaluation of correlation of diaphragmatic excursion and diaphragm thickening fraction with train of four ratio in patients undergoing laparoscopic surgeries under general anaesthesia: A prospective observational study

This clinical study involves 61 patients undergoing elective laparoscopic surgeries under general anesthesia from August 15 2025 to February 15th 2026 at a tertiary care teaching hospital. After ethical approval and consent, patients will undergo preoperative evaluations including BMI, demographic data, and airway examination. On surgery day, diaphragmatic ultrasound (DUS) parameters (DE, DTF) will be recorded pre- and post-operatively. General anesthesia will be induced using IV fentanyl (2 mcg/kg) and propofol (2 mg/kg), followed by vecuronium (0.1 mg/kg) for muscle relaxation. Neuromuscular monitoring (TOF count and TOFR) will guide vecuronium dosing and extubation readiness. Post-surgery, neostigmine and glycopyrrolate will be used for reversal, and patients will be extubated once stable and awake.