Effect of Sarcopenia and Frailty on Rocuronium Pharmacodynamics in Geriatric Patients

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