Discussion
postoperative cognitive impairment, muscle blockade
DEGENERATION, MUSCLE RELAXATION, NEUROMUSCULAR BLOCKADE, POSTOPERATIVE COMPLICATIONS, COMPLICATION
This study explored the optimal dose of neostigmine in elderly patients to reverse the TOF value to 0.9. The results indicated that the dose of 40 µg/kg may be an optimized choice and did not increase the incidence of postoperative cognitive impairment or PONV.Incomplete neuromuscular recovery after general anesthesia is a common complication in patients after general anesthesia, with an incidence ranging from 31 to 64% [Elderly patients are prone to residual muscle relaxation due to organ function degeneration and physiological changes that lead to slow metabolism of neuromuscular blockers [The results of this study show that neostigmine was used for antagonism at the end of surgery, and even a small dose (20 µg/kg) can significantly accelerate muscle function recovery; but 40 µg/kg can achieve the purpose of rapid reversal of muscle blockade effect, further increasing the dose (50 µg/kg) cannot significantly shorten the time for muscle recovery. It suggested that a dose of 40 µg/kg of neostigmine may be an optimized choice to reverse the effects of muscle relaxants quickly, without increasing postoperative complications.Previous studies have explored the dose of neostigmine required for reversal of neuromuscular blockade. Preault A et al.[Additionally, our study found that the use of neostigmine to antagonize muscle relaxation at the end of surgery did not significantly shorten the postoperative PACU stay time of patients, which may be affected by confounding factors such as surgical type, analgesic sedative drugs and wound drainage at the end of surgery. Subsequent further trials should limit and standardize trial conditions, reduce related confounding factors and increase sample size to clarify the role of neostigmine in shortening PACU stay.