A Comparision of the Effect of Sugammadex on the Recovery Period and Postoperative Residual Block in Young Elderly (65-74) and Middle-Old Elderly (>74) Patients

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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. Aims: 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-old elderly patients who underwent elective laparoscopic cholecystectomy, followed by a train of four (TOF) Watch monitorization. Methods: Sixty patients over the age of 65 with ASA I-III were divided into two groups according to their age (65-74 years old and older than 74 years ). 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 equal to 0.9 value. The patients’ TOF responses were evaluated with regards to PORC in at the fifth minute and were followed up for one hour in the recovery room. Reintubation was applied for those patients who developed PORC and had SpO2 less than 90% despite being given 6L oxygen per min with a face mask Results: The onset time of neuromuscular blocking agent and time from T2 to achieve TOF ratio 90% or over were found to be longer in the middle-old 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 onset of the sugammadex effect is prolonged for patients who are aged older than 74 years compared to patients aged between 65-74 years.