title: A Comparision of the Effect of Sugammadex on the Recovery Period and Postoperative Residual Block in Young Elderly and Middle-Aged Elderly Patients.
abstract: BACKGROUND
  The importance of the characteristics of anesthesia and postoperative residual curarization (PORC) in the elderly population should be a growing concern in this century.
  
  
  OBJECTIVE
  To investigate the effect of sugammadex on the duration of the recovery from neuromuscular blocking agents and postoperative residual curarization in the young elderly and middle-aged elderly patients who underwent elective laparoscopic cholecystectomy, followed by a train of four (TOF) watch monitorization.
  
  
  METHODS
  Prospective clinical trial study.
  
  
  METHODS
  Sixty patients over the age of 65 with American Society of Anesthesiologists I-III were divided into two groups according to their age (65-74 years old and ≥75 years old). Patients received sugammadex (2.0 mg/kg iv) at the reappearance of the second twitch of the TOF as an agent for reversal of neuromuscular blockage at the end of surgery. Patients were extubated at the time of TOF ≥0.9. The patients' TOF responses were evaluated with regards to PORC in at the 5th minute and were followed up for one hour in the recovery room. Reintubation was applied for those patients who developed PORC and had peripheric oxygen saturation <90% despite being given 6 L oxygen per min with a face mask.
  
  
  RESULTS
  The onset time of neuromuscular blocking agent and time from T2 to achieve TOF ratio 90% (the duration of sugammadex effect) or over were found to be longer in the middle-aged elderly group than in the young elderly group. A statistically significant relationship was found between age and the duration of TOF ratio to reach 0.9 in the same direction. The PORC incidence and rate of reintubation were found to be 1.7% in all patients.
  
  
  CONCLUSIONS
  In our opinion, it is necessary to remember that the duration of sugammadex effect on the recovery period is prolonged for patients who are aged ≥75 years compared to patients aged between 65-74 years. (ClinicalTrials.gov Identifier: ACTRN12615000758505).
authors.affiliation: Department of Anesthesiology and Reanimation, Şırnak State Hospital, Şırnak, Turkey.
authors.forename: Emine
authors.initials: E
authors.lastname: Yazar
authors.affiliation: Department of Anesthesiology and Reanimation, Bursa Şevket Yılmaz Training and Research Hospital, Bursa, Turkey.
authors.forename: Canan
authors.initials: C
authors.lastname: Yılmaz
authors.affiliation: Department of Anesthesiology and Reanimation, Uludağ University School of Medicine, Bursa, Turkey.
authors.forename: Hülya
authors.initials: H
authors.lastname: Bilgin
authors.affiliation: Department of Anesthesiology and Reanimation, Bursa Şevket Yılmaz Training and Research Hospital, Bursa, Turkey.
authors.forename: Derya
authors.initials: D
authors.lastname: Karasu
authors.affiliation: Department of Anesthesiology and Reanimation, Uludağ University School of Medicine, Bursa, Turkey.
authors.forename: Selcan
authors.initials: S
authors.lastname: Bayraktar
authors.affiliation: Department of Anesthesiology and Reanimation, Bursa Şevket Yılmaz Training and Research Hospital, Bursa, Turkey.
authors.forename: Yılmaz
authors.initials: Y
authors.lastname: Apaydın
authors.affiliation: Department of Anesthesiology and Reanimation, Bursa Şevket Yılmaz Training and Research Hospital, Bursa, Turkey.
authors.forename: Halil Erkan
authors.initials: HE
authors.lastname: Sayan
keywords: Elderly; postoperative residual curarization; reintubation; sugammadex