Neuromuscular Blocking Agents on Gastrointestinal Function Following Colorectal Surgery

Exclusion Criteria

• •Presence of psychiatric disorders, cognitive impairment, or language communication barriers that may affect assessment compliance.
• •Body Mass Index (BMI) ≥ 35 kg/m².
• •Severe hepatic dysfunction (Child-Pugh Class C) or renal dysfunction (estimated glomerular filtration rate \< 30 ml/min/1.73m² and/or receiving renal replacement therapy).
• •Pre-existing severe gastrointestinal dysfunction (e.g., intestinal obstruction, active inflammatory bowel disease, severe constipation/diarrhea); receipt of neoadjuvant therapy preoperatively; planned stoma creation surgery; or scheduled for low rectal surgery (e.g., low anterior resection, abdominoperineal resection).
• •History of neuromuscular disorders (e.g., myasthenia gravis) or malignant hyperthermia.
• •History of opioid abuse, or chronic non-surgical pain requiring long-term analgesic therapy.
• •Anticipated difficult airway, or patients planned for postoperative transfer to the intensive care unit (ICU) while intubated.
• •Contraindications to the use of neostigmine, atropine, sugammadex, or rocuronium (e.g., known drug allergy, epilepsy, unstable angina, asthma, glaucoma, uncontrolled malignant arrhythmias especially atrioventricular block, severe cardiac valve stenosis); or current use of medications that may significantly influence the effects of neuromuscular blocking agents (e.g., antibiotics such as tetracyclines, aminoglycosides, polymyxins, and clindamycin; antiepileptic drugs; lithium; certain antidepressants such as sertraline and amitriptyline).
• •Pregnant or lactating women.
• •Current participation in other clinical trials that may interfere with the results of this study.