Background:The importance of the characteristics of anesthesia and postoperative residual curarization (PORC) in the elderly population should be a growing concern in this century. Aims: To investigate the effect of sugammadex on the duration of the recovery from neuromuscular blocking agents and postoperative residual curarization in the young elderly and middle-aged elderly patients who underwent elective laparoscopic cholecystectomy, followed by a train of four (TOF) watch monitorization. Study Design: Prospective clinical trial study. Methods: Sixty patients over the age of 65 with American Society of Anesthesiologists I-III were divided into two groups according to their age (65-74 years old and ≥75 years old). Patients received sugammadex (2.0 mg/ kg iv) at the reappearance of the second twitch of the TOF as an agent for reversal of neuromuscular blockage at the end of surgery. Patients were extubated at the time of TOF ≥0.9. The patients' TOF responses were evaluated with regards to PORC in at the 5th minute and were followed up for one hour in the recovery room. Reintubation was applied for those patients who developed PORC and had peripheric oxygen saturation <90% despite being given 6 L oxygen per min with a face mask. Results: The onset time of neuromuscular blocking agent and time from T 2 to achieve TOF ratio 90% (the duration of sugammadex effect) or over were found to be longer in the middle-aged elderly group than in the young elderly group. A statistically significant relationship was found between age and the duration of TOF ratio to reach 0.9 in the same direction. The PORC incidence and rate of reintubation were found to be 1.7% in all patients. Conclusion: In our opinion, it is necessary to remember that the duration of sugammadex effect on the recovery period is prolonged for patients who are aged ≥75 years compared to patients aged between 65-74 years. (ClinicalTrials.gov Identifier: ACTRN12615000758505) Keywords: Elderly, postoperative residual curarization, reintubation, sugammadex Young elderly people, middle-aged elderly people, and old elderly people have been classified, respectively, between 65-74 years of age, between 75-84 years of age, and over age 84 by gerontologists (1). A number of studies have indicated that the prevalance of postoperative residual curarization (PORC) increases with age (2,3).The principle of train of four (TOF) Watch was to indicate a pattern of stimulation that did not require the comparison of evoked responses to a control response obtained before administration of a neuromuscular blocking agent (NMBA). As well as enabling the observer to compare T 1 (first twitch of the TOF) to T 0 (control), it also enables comparison of T 4 (fourth

A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Shoulder pain is usually caused by overuse of shoulder girdle. In elderly, degenerative changes are responsible from pain. In these cases, it can possible that development of shoulder pathologies coincidency with advanced gonarthrosis in high body mass indexed (BMI) patients related to movements supported by shoulder in daily life. The aim of this study is to investigate the relationship between advanced gonarthrosis, BMI and shoulder pathologies. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : 122 patients included in this study whom diagnosed with advanced gonarthrosis (grade 3-4) by Kellgren-Lawrence criterias and concurrently have shoulder pathologies from 269 patients. Patients classified on their BMI indexes to four groups. All patients were evaluated with their radiologic findings and Constant-Murley shoulder scoring system. R Re es su ul lt ts s: : Totally 122 patients were included in the study; 24 (19.7%) were male and 98 (80.3%) were female. The mean age of the patients was 69.75±4.41 years. There was no statistically significance between groups regarding to mean of age, sex and side distribution (p>0.05). There was statistically significant difference in Constant-Murley shoulder scoring system between the groups (p:0.001; p<0.05). C Co on nc cl lu us si io on n: : In daily life, lower extremity is responsible from body movement while upper extremity is not used in this activity. But, overuse of upper extremity, especially shoulder joint increases in lower extremity pathologies. In these cases, shoulder pathologies are significantly increased in high Body Mass index and advanced gonarthrosis related to decrease in body movements and increase in shoulder based movements. It is important to evaluate clinically concurrently shoulder pathologies in these patients.K Ke ey y W Wo or rd ds s: : Shoulder; osteoarthritis; body mass ındex Ö ÖZ ZE ET T A Am ma aç ç: : Omuz ağrıları çoğu zaman kol ve omuz bölgesinin çok kullanılmasına bağlı olarak gelişmek-tedir. İlerleyen yaşlarda ise omuz ekleminin dejeneratif değişikliklerine bağlı olarak daha da artabilir. Bu durumda; vücut kitle indeksi (VKI) yüksek, ileri evre gonoartrozlu hastalar için, günlük yaşamda omuz destekli hareketlerin artmasına bağlı omuz patolojilerinin gelişmesi söz konusudur. Bu çalışmada ileri evre gonartroz, VKI ve omuz şikayetleri arasındaki ilişki değerlendirildi. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Kellgren-Lawrence kriterlerine göre ileri evre (evre 3-4) gonartroz tanısı alan 269 hastalar arasından eş zamanlı omuz ile ilgili şikayeti olduğu tespit edilen 122 hasta çalışmaya dahil edildi. Vücut kitle indekslerine göre gruplandırılan ve 4 gruba ayrılan hastalar mevcut radyolojik tetkikleri ve Constant-Murley omuz skorlamaları ile değerlendirildiler. B Bu ul lg gu ul la ar r: : Çalışmaya katılan hastaların 24'ü (%19.7) erkek, 98'i (%80.3) kadın, yaş ortalamaları 69.75±4.41 yıldır. Gruplar arasında yaş ortalamaları, cinsiyet ve taraf dağılımları açısından ...