Effect of sugammadex, reversing the effects of rocuronium, on steroid hormone levels

In this study, the effect of sugammadex, a recently introduced alternative to traditional decurarization by cholinesterase inhibitors, on adrenal cortical hormones has been examined. After local ethics committee approval were obtained and written informed patient consent will obtain, a total of 50 male patients between 18 and 45 years of age with an ASA (American Anesthesiology Association) class of I or II undergoing elective lower extremity surgery with an expected surgery time of 1 to 3 hours will include in this study. Prior to surgery, patients will categorize into two groups (neostigmin group, Group N; and sugammadex group, Group S). In addition to standard monitorization, train-of-four (TOF ) is going to used to monitorize the level of neuromuscular blockade. Standard induction (propofol, rocuronium, remifentanyl) and maintenance (seovoflurane, O2) of anesthesia will perform. At the termination of surgery, neuromuscular blockade will antagonise using 0.05 mg/kg of neostigmine and 0.01 mg/kg of atropin in Group N and using 4 mg/kg sugammadex in Group S when spontaneous recovery of neuromuscular blockade occurs with the reappearance of T2. A total of three blood samples, just before and 15 minutes and 4 hours after antagonism, will obtain in each patient to determine serum aldosterone, cortisol, progesterone, and free testosterone levels.