Comparative Study for the Efficacy of Sugammadex 1mg/kg and 2mg/kg for the Reversal of Neuromuscular blockade after Vecuronium for patients undergoing Elective surgery Under General Anaesthesia

After preoperative anaesthetic evaluation on the day of admission, the patients satisfying the criteria for selection will be explained about the procedure and consent will be obtained. Patient’s nil per oral status 6hrs for solids, 2 hours for liquids will be confirmed and shifted inside the operation theatre. The standard monitors will be connected and basal physiological parameters will be measured and mechanosensor based on kinemyography (TOF,GE healthcare) NM T will be attached to thumb and index finger of the patient and one brown electrode is placed on ulnar side 2cm below wrist joint and other white electrode is placed2cm below the 1st electrode. The mechanosensor measures the motion or the thumb with a piezoelectric sensor,which converts the physical motion to an electrical signal and quantifies the evoked mechanical response. The maximum twitch response will be noted. The patient will be given premedication with Inj Glycopyrrolate0.01 mg/kg, Inj Fentanyl 2mcg/kg, then preoxygenated with 100% oxygen for 3 minutes followed by Intravenous induction with Inj Propofol 2mg/kg and before administration of Inj Vecuronium 0. Img/kg. Repititve train-of-ratio(TOF)stimulation will be applied at ulnar nerve at the wrist every 15s until the end of anaesthesia or atleast until recovery of the TOF ratio().9. Body temperature will be maintained at ?35.0 0 C. Tracheal intubation will be performed after onset of complete blockade. Maintainence with Oxygen:Air/N20 according to the patient need and inj Vecuronium 0.020.03mg/kg administered as needed at reappearance of second twitch(T2) of the TOF if clinically required.At reappearance of T2 after last dose of vecuronium, Sugammadex I mg/kg in one group and 2m/kg in other group will be administered. After the TOF ratio >().9 tracheal extubation will be done. The assessments includes the level of consciousness (awake and oriented, arousable with minimal stimulation, or responsive only to tactile stimulation), muscle strength (ability to independently transfer from surgery table to bed, head tilting, and hand squeezing), and a 5-s head lift test. The respiratory frequency and pattern of the patient will be monitored and pulse oximetry will be performed in the PACU for at least 2 hours after the recovery of the TOF ratio to 0.9.