Effect of Sarcopenia and Frailty on Rocuronium Pharmacodynamics in Geriatric Patients

This prospective observational study aims to evaluate whether sarcopenia and frailty affect the pharmacodynamic profile of rocuronium in geriatric patients undergoing elective surgery under general anesthesia.

Inclusion Criteria: * Scheduled to undergo elective surgery under general anesthesia requiring endotracheal intubation * Planned use of rocuronium for neuromuscular blockade * Quantitative neuromuscular monitoring planned during anesthesia * American Society of Anesthesiologists physical status I-III * Ability to provide written informed consent * Completion of preoperative frailty and sarcopenia assessment Exclusion Criteria: * Emergency surgery * Known neuromuscular disease * History of allergy or contraindication to rocuronium, sugammadex * Severe hepatic insufficiency * Severe renal insufficiency * Use of drugs known to significantly affect neuromuscular transmission * Preoperative mechanical ventilation or intensive care unit admission * Inability to perform a frailty or sarcopenia assessment * Patients in whom quantitative neuromuscular monitoring cannot be properly performed * Refusal to participate in the study