Anesthesia and monitoring
NEUROMUSCULAR BLOCKADE
Anesthetic providers were blinded to group allocation and used a standardized anesthetic protocol. No premedication was given to any of the participants. Anesthesia was induced with total intravenous (IV) anesthesia with propofol, remifentanil, and rocuronium (0.8 mg/kg) using target-controlled infusion (Orchestra® Base Primea; Fresenius Kabi, Brezins, France). The effect site concentration of propofol and remifentanil were adjusted to achieve a bispectral index of 40–60 and to maintain mean arterial blood pressure and heart rate to the pre-induction value. At the end of the surgery, neuromuscular blockade was antagonized with 250 μg/kg pyridostigmine and 10 μg/kg glycopyrrolate. All patients received IV patient-controlled analgesia (PCA) with fentanyl programmed to deliver 15 μg/h (1mL/h) with a 15-μg bolus (1mL) dose and a 15-minute lockout time.