Abstract:Objective To compare the muscle relaxant effects of rocuronium bromide and cisatracurium besylate in laparoscopic radical cystectomy for bladder cancer, as well as their impacts on pulmonary ventilation function and body's inflammatory response. Methods A total of 112 patients scheduled for laparoscopic radical cystectomy at the Inner Mongolia People's Hospital between January 2022 and June 2024 were randomly divided into the RB group (n=56, receiving rocuronium bromide as the muscle relaxant) and the CB group (n=56, receiving cisatracurium besylate as the muscle relaxant). The muscle relaxant effects, tracheal intubation condition ratings, and adverse reaction were compared between the two groups. Mean arterial pressure (MAP), heart rate, saturation of peripheral oxygen (SpO₂), and pulmonary ventilation function indicators [percentage area of center of ventilation (CoV), dependent silent spaces (DSS), and non-dependent silent spaces (NSS)] were recorded and compared immediately before anesthesia induction (T0), immediately after tracheal intubation (T1), immediately after tumor resection (T2), and immediately after surgery (T3). The levels of inflammatory markers [high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor- α (TNF-α), and white blood cell count (WBC)] were compared between the two groups before surgery and 2 hours after surgery. Results The onset time of muscle relaxation in the RB group was shorter than that in the CB group (P< 0.05), while the duration of muscle relaxation, recovery index, and extubation time in the RB group were longer than those in the CB group (P<0.05). The excellent rate of tracheal intubation conditions in the RB group was higher than that in the CB group [94.64% (53/56) vs 81.14% (46/56), χ²=4.264, P=0.039]. At T1, MAP and heart rate in the RB group were significantly lower than those in the CB group (P<0.05). SpO₂ in the RB group was significantly higher than that in the CB group at T1 and T2 (P<0.05). Compared with T0, CoV significantly decreased at T1, T2, and T3 in both groups (P<0.05), while DSS significantly increased (P<0.05). Two hours after surgery, hs-CRP, TNF-α, and WBC levels in CB group were higher than those in RB group (P<0.05). There was no significant difference in the incidence of adverse reactions between RB group and CB group [14.29% (8/56) vs 19.64% (11/56), χ²=0.571, P=0.450]. Conclusion The use of rocuronium bromide in laparoscopic radical cystectomy for bladder cancer provides better muscle relaxation compared to cisatracurium besylate, and can alleviate surgery-induced inflammatory responses. However, both have similar effects on pulmonary ventilation function.