Continuous intraoperative neuromonitoring is currently the gold standard technique available to prevent recurrent laryngeal nerve injuries. It significantly reduces the complication rate compared with intermittent intraoperative neuromonitoring, and represents significant progress in thyroid surgery, particularly in cases of more difficult dissections.
There are, however, some technological and interpretative limits related to the lack of standardization of continuous intraoperative neuromonitoring and the prolonged length of time employed in the surgical positioning of the probe, despite various proposed approaches to the vagal nerve.
Nonetheless, this method can be considered a safe and modern approach to thyroid surgery that reduces post-surgical complications and provides useful information.

Primary hyperparathyroidism (pHPT) is a frequently seen endocrine disease, and its main treatment is surgery. In the majority of pHPT, the disease involves only a single gland, and the majority of the pathological glands can be determined by preoperative localization methods.In addition to preoperative localization studies in parathyroidectomy, the use of adjunct methods to improve intraoperative localization in order to increase success of surgery is becoming widespread. These methods include different approaches, mainly intraoperative parathyroid hormone (PTH) measurement, followed by intraoperative gamma probe application, intraoperative ultrasonography, parathyroid imaging with methylene blue, and frozen section examination. Recently, especially promising new imaging methods have been described in the literature with various optical technologies to increase the localization of the parathyroid glands and to evaluate their viability. These methods include parathyroid imaging with autofluorescence, indocyanine green imaging with autofluorescence, autofluorescence imaging with methylene blue, autofluorescence imaging with 5-aminolevulinic acid, optical coherence tomography, laser speckle contrast imaging, dynamic optical contrast imaging, and Raman spectroscopy. Currently, minimally invasive parathyroidectomy has become the standard treatment for selected pHPT patients with the aid of preoperative imaging and intraoperative auxiliary methods. The aim of the present study was to evaluate the routinely used new promising intraoperative adjunct methods in pHPT.

Concomitant diseases in elderly individuals with diabetes (renal failure, heart failure, ischemic heart disease, stroke, urinary incontinence, cognitive impairment, dementia, sarcopenia, and osteoporosis) make diabetes management difficult. Therefore, other comorbid conditions should be taken into account in elderly diabetics when considering a treatment approach. The use of oral antidiabetic agents in individuals older than 75 years may be limited. Although the diabetes treatment is not any different in healthy elderly patients, hypoglycemia is one of the most feared conditions, especially in the elderly. Therefore, metformin, DPP-IV inhibitors, and SGLT2 inhibitors should be considered in the first place with less risk of hypoglycemia. Low-dose sulfonylureas may also be used in selected cases. The use of new antidiabetic drugs, such as GLP-1 anologues and SGLT2 inhibitors, has strengthened our ability to cope with the risk of hypoglycemia and cardiovascular events, which are the two most important drawbacks in the treatment of elderly people with diabetes. Insulin treatment should be individualized, and the most rare injection regimens should be used. In case of failure of OAD, basal insulin should be added to the current treatment, and if necessary, a basal + plus regimen should be planned by adding bolus insulin 1/2/3 times per day to the meals. As a result, in elderly diabetics, an inadequate treatment or excessive treatment and individualizing the treatment should be the most appropriate approach.

Developmental dysplasia of the hip (DDH) is still one of the biggest orthopedic problems in the world. Global poverty and refugee crises have led to it becoming a greater issue even in developed nations. Early diagnosis and effective treatment of DDH are required to prevent the possibility of arthrosis, limb shortening, pelvic asymmetry, and vertebral scoliosis. In late cases, surgery is the only choice for correction. Direct radiography has been used for many years and continues to have an important role, though ultrasonography is the primary source for early postnatal screening. Although magnetic resonance imaging (MRI) has become an important modality to provide sectional imaging in many cases, in late-period dysplasia, computed tomography (CT) and three-dimensional (3D) CT are preferred because it can more effectively demonstrate the cortical bony structures. The aim of this review was to demonstrate the effectiveness of 3D CT and multiplanar reconstruction based on previous studies.

Objectives: The aim of this study was to determine the technical problems in pediatric laparoscopic surgery and to evaluate its results.
Methods: The technical problems encountered in 30 laparoscopic operations performed between 3 November 2012 and 31 December 2017 were retrospectively analyzed.
Results: The technical problems experienced in 30 laparoscopic surgeries were analyzed. There were 6 splenectomies, 15 appendectomies, 1 hernioplasty, 2 ovarian cyst excisions, 4 cholecystectomies, 1 intra-abdominal exploration of the testes, and 1 varicocele surgery. The technical errors included instrument failure in 10, human errors in 8, device problems in 12, and multiple problems in 2 cases. In 5 patients, we switched to open surgery.
Conclusion: Technical problems prolong the operation, and cause a conversion to open surgery. In order to solve these problems, it is necessary to register and report these problems and take the necessary preventive measures.

Objectives: Single-incision laparoscopic procedures have been gaining popularity in recent years due to their minimal incisional morbidity and improved cosmetic outcomes. Herein, we will compare the feasibility and outcomes of single-incision and conventional multiport laparoscopic distal pancreatectomy.
Methods: This study involves consecutive patients who underwent either single-incision or conventional multiport laparoscopic distal pancreatectomy from March 2007 to February 2014. The patients were divided into two groups, based on the surgical approach: single-incision laparoscopic surgery (Group 1) and conventional multiport laparoscopic surgery (Group 2). The parameters evaluated included estimated blood loss, operative time, postoperative pain, duration of hospital stay, complications, conversion, and final pathology.
Results: There were a total of 20 patients, 10 in each study group. Baseline characteristics were similar, and there was no mortality in either of the groups. The low-flow pancreatic fistula was the most commonly seen morbidity, but it was ceased spontaneously in each group by a ratio of 30%. The operative time was significantly shorter in Group 2, with a mean of 116 minutes versus a mean of 180 minutes for Group 1 (p<0.001). One of the procedures in Group 2 was converted to open surgery due to peroperative bleeding. The median follow-up periods of the patients were 22 months and 56 months. The spleen was preserved in only 1 patient from Group 1, whereas in Group 2, the spleen preservation was achieved in 5 patients.
Conclusion: The single-incision laparoscopic technique is a safe and effective alternative to standard laparoscopic distal pancreatectomy.

Objectives: The aim of this study is observing the clinicopathologic features of thyroid papillary microcarcinomas (PTMs) and comparing these features with papillary thyroid carcinoma (PTC).
Methods: A total of 86 surgically treated patients suffering from PTC were evaluated retrospectively. Group 1 (G1) included patients with a tumor <1 cm, while Group 2 (G2) included patients with a tumor >1 cm. The two groups were compared in terms of the preoperative thyroid-stimulating hormone (TSH) level, anti-thyroid peroxidase antibody (anti-TPO) and antithyroglobulin antibody (TgAb) values, multicentricity, the lymphovascular invasion rate, the presence of extrathyroidal extension, and central and/or lateral lymph node metastasis.
Results: There was no statistically significant difference observed between the groups in terms of the preoperative TSH level, anti-TPO, and TgAb values. The rate of multicentricity of the tumor in G2 was 66%, while it was 36% in G1 (p<0.001). The lymphovascular invasion rate in G1 was 14.2%, while it was 61% in G2 (p<0.001). The extrathyroidal extension rate of the tumor cells in G1 was 21.4%, while it was 63.6% in G2 (p<0.001). The central lymph node metastasis rate in G2 was 38.6%, while it was 4.8% in G1 (p<0.001). The lateral lymph node metastasis rate in G2 was 20.5%, while it was 0% in G1 (p<0.001).
Conclusion: PTMs are generally associated with good prognostic factors with high survival rates. However, the risk factors such as multifocality, extrathyroidal extension, and lymphovascular invasion increasing the recurrence risk are not rare in PTM. Thus, the patients having these histopathological features of the tumor should be followed more carefully.

Objectives: Although malignant melanoma accounts for 3% of skin cancers, it is responsible for 75% of deaths associated with skin cancer. In our study, all melanoma cases diagnosed and treated at our clinic were retrospectively reviewed, and the cases of unknown primary origin among them were examined in detail in terms of diagnosis and treatment.
Methods: The patients with malignant melanoma treated at the inpatient services of our clinic between January 1991 and April 2017 were retrospectively screened in the records. These patients were evaluated for age, sex, tumor type, Breslow depth, metastasis, and treatment. Among these patients, four cases of unknown primary origin were examined in detail.
Results: During January 1991 and April 2017, 173 patients received inpatient care for malignant melanoma at our clinic. As regards to the melanoma subtypes, nodular type in 45 patients, acral lentiginous type in 43 patients, superficial spreading type in 63 patients, lentigo maligna melanoma in 15 patients, subungual type in 7 patients, and either unidentified melanoma or other subtypes in 10 patients were identified.
Conclusion: The ideal treatment of a patient with melanoma is multidisciplinary, with plastic surgery having a central role.

Objectives: The mean platelet volume (MPV) and the MPV-to-platelet (PLT) count ratio have long been reported as inflammation markers. In this study, we aimed to investigate the predictive value of the MPV and the MPV-to-PLT ratio on surgical wound healing in patients who underwent abdominal hysterectomy and experienced infections at the surgical site following surgery, despite adequate antimicrobial treatment.
Methods: A total of 100 patients who encountered surgical wound infection (SWI) after abdominal hysterectomy were enrolled retrospectively. Samples for complete blood count were drawn the day before the operation. All patients received preoperative and postoperative antibiotic prophylaxis and proper antimicrobial treatment following the SWI development. Patients’ condition resolved after standard care and antimicrobial agents were classified as the standard care group. Others, in whom an improvement despite the standard care was not observed, underwent delayed primary closure and were classified as the delayed primary closure group.
Results: The PLT count was decreased (319.5±66 103/µL vs. 392±121 103/µL; p<0.05), MPV(9.2±1.3 fL vs. 8.2±1.5 fL; p<0.05), and the MPV-to-PLT ratio (0.030±0.006 vs. 0.024±0.014; p<0.05) was increased in the delayed primary closure group compared to the standard care group. A receiver operating characteristic curve analysis was performed to determine the predictive value of these parameters on the response to standard care measures providing 8.28fL as a cut-off value for MPV (AUC=0.647, 72% sensitivity and 52% specificity) and 0.025 as a cut-off value for the MPV-to-PLT ratio (AUC=0.750, 75% sensitivity and 67% specificity) for predicting nonresponsiveness.
Conclusion: An increased preoperative MPV and the MPV-to-PLT ratio may predict poor wound healing following total abdominal hysterectomy.

Objectives: This study aimed to analyze the efficacy of single-dose tranexamic acid (TA) 20 mg/kg preoperatively to reduce blood loss in patients undergoing total knee replacement (TKR).
Methods: A total of 387 patients (82 males, 305 females) undergoing TKR between January 2014 and December 2018 were included in the study. The T + group was administrated intravenous (iv) TA 20 mg/kg 20 min before the skin incision. We determined perioperative blood loss, the amount of drainage postoperative 24 h, the amount of drainage after postoperative 24–48 h, total volume of drains, total volume of blood loss, postoperative hemoglobin and hematocrit levels, and amount of total blood transfusion.
Results: In terms of demographic data, no statistically significant difference was observed between the groups. Perioperative blood loss and total volume of blood loss was found statistically higher in T − group compared to T + group. Postoperatively, the mean hemoglobin and hematocrit levels of T − group were statistically significantly lower than T + group.
Conclusion: A single 20 mg/kg iv TA administration before TKR reduces bleeding during surgery and within 24 h postoperatively.

Objectives: We aim to investigate intubation conditions, intubation times, and hemodynamic response with the GlideScope video laryngoscope or the Macintosh direct laryngoscope for orotracheal intubation in children older than one year.
Methods: Eighty patients aged 1–12 years, scheduled to undergo elective surgery under general anesthesia with endotracheal intubation were included in a prospective, single-blinded, randomized trial. Exclusion criteria were risk of pulmonary aspiration, craniofacial malformation, difficult intubation, emergency surgery, cardiovascular disease, respiratory disease, and hemodynamic instability. After standard anesthesia induction, patients were randomized into two groups. The group G patients (n=40) were intubated with the GlideScope and the group M patients (n=40) were intubated with the Macintosh laryngoscope. Intubation time, number of attempts, Cormack–Lehane score, airway maneuvers, and visual analog score were recorded. Hemodynamic variables were recorded before and after anesthesia induction, at intubation, and 1., 3., and 5. minutes after intubation. Student’s t-test, Mann–Whitney U test, and the χ2 test were used for statistical analysis, with p<0.05 considered significant.
Results: The demographic data, operation time and hemodynamic parameters were similar between the two groups. The intubation time was longer in Group G than Group M. The incidence of Cormack–Lehane score 1 was higher in Group G than Group M while Cormack–Lehane score 2 was higher in Group M.
Conclusion: We concluded that the GlideScope video laryngoscope provided better glottis visualization, but prolonged intubation time. There was no superiorty on hemodynamic effect with the video laryngoscope.

Objectives: The aim of the present study was to investigate the effect of previous spinal surgery on intradiscal ozone–oxygen (O2–O3) treatment in low back pain associated with lumbar disc herniation (LDH).
Methods: Patients who underwent intradiscal O2–O3 therapy for LDH-induced low back pain were screened retrospectively from hospital records. To ensure homogenization of participants, patients who had received O2–O3 therapy to L4–L5 and L5–S1 intervertebral discs, those with pre-injection and post-injection month 1 data, and those who completed the first year of treatment were included in the study. Patients who completed the first year of treatment but with missing data were contacted and followed up by phone. Patients who underwent surgery at the same level as the injection level were classified as Group 1 (n=30), and those without surgery were classified as Group 2 (n=43). Pain and disability were measured by Visual Analog Scale (VAS) and Oswestry Disability Index (ODI), respectively.
Results: There was no statistically significant difference between the pre-injection VAS and ODI scores of the groups (p=0.719 and p=0.108). Group 1 had significantly higher VAS and ODI scores on month 1 and year 1 than Group 2, and statistically significant decreases were seen in VAS and ODI scores in both groups at follow-up (p<0.001 for all). There was no statistically significant difference between month 1 and year 1 VAS evaluations of the groups with respect to ≥50% improvement in pain reduction (p=0.213 and p=0.347).
Conclusion: In the present study, the effect of the history of spinal surgery on intradiscal O2–O3 treatment results was investigated. Intradiscal injection was found to be effective for both groups, but more successful results were obtained in patients without surgical history.

Objectives: Ankaferd BloodStopper (ABS) is a topical hemostatic agent that modulates the inflammatory response and accelerates wound healing. The aim of this study was to determine the effects of ABS on the colon anastomosis wound healing in a rat model.
Methods: Thirty-two Wistar albino rats were divided into four groups as follows: Group A (n=8), left colonic anastomosis plus ABS treatment (sacrificed on the 3rd day); Group B (n=8) (control), left colonic anastomosis (sacrificed on the 3rd day); Group C (n=8), left colonic anastomosis plus ABS treatment (sacrificed on the 7th day); and Group D (n=8) (control), left colonic anastomosis (sacrificed on the 7th day). All rats were sacrificed at the end of the experiment to assess the anastomosis integrity and the presence of perianastomosis abscesses, peritonitis, and adhesions. Additionally, the bursting pressure and hydroxyproline (OH-pyroline) levels were determined, and a histopathologic evaluation of the perianastomosis tissue was conducted.
Results: The mean bursting pressure on Day 7 was significantly higher than that on Day 3 in the ABS group (p=0.017). Overall, the bursting pressure was higher in animals treated with ABS than in the control animals, although the difference was not statistically significant. The OH-pyroline levels of both ABS groups were significantly higher than in the control groups. The mean OH-pyroline level on Day 7 was higher than that on Day 3 in the ABS-treated animals (p=0.038).
Conclusion: ABS increases collagen formation and neovascularization, and it has a positive impact during the colon anastomosis healing in an experimental model of wound healing.

Objectives: The aim of this study was to determine the level of knowledge of pediatric residents and practicing pediatricians about cow’s milk allergy (CMA) and to evaluate the effect of occupational education.
Methods: Pediatric residents and pediatricians were included in the study. A survey about CMA was administered to the participants before and after occupational training.
Results: A total of 45 doctors were included in the study. Of the group, 31 were pediatric residents and 14 were practicing pediatricians. The pediatric resident group had a mean of 2.3 years professional experience, and the mean was 8.9 years in the pediatrician group. The mean number of correct answers of a possible score of 10 before the training was 8.32±1.37 in the resident group and 7.5±1.69 in the pediatrician group. There was no significant difference between the groups (p=0.09). The mean number of correct answers after training was 10 in the pediatric resident group, and 9.71±0.6 in the pediatrician group. The difference between the groups was statistically significant (p=0.01). Intragroup evaluation post training revealed significantly higher scores (p=0.001).
Conclusion: The results of this study indicate that occupational education significantly increased the level of knowledge about CMA in both pediatric residents and practicing pediatricians.

Objectives: The aim of this study was to evaluate factors that affected decisions regarding breastfeeding and complementary feeding practices in children aged 24 to 48 months.
Methods: Children aged 24 to 48 months who were presented at the outpatient clinic of a single hospital over a 6-month period were included in the study. Children who were born prematurely, hospitalized in the neonatal intensive care unit, and those with a chronic disease were excluded. A questionnaire was administered to parents who provided consent. Data related to demographic characteristics, socioeconomic status, and infant nutrition practices were collected and analyzed.
Results: A total of 100 cases were included. The distribution of the gender of the children was 49% female and 51% male, and the mean age was 36.2±7.8 months. The mean duration of exclusive breastfeeding was 4.83±1.23 months, the mean length of total breastfeeding was 17.65±8.44 months, and the mean initiation of complementary feeding was 5.71±1.23 months of age. The most frequent reason provided for the cessation of breastfeeding was the mother’s decision to wean. The duration of exclusive breastfeeding and the total length of breastfeeding feeding was significantly shorter among children who were born by cesarean section, and those who used a pacifier and or feeding bottle. Non-working mothers used formula for a longer period (p=0.043) and introduced solid foods and the use of utensils later than other mothers (p=0.001, p=0.03, respectively). Complementary food was provided to the infants of families whose monthly income level was less than TL 1000 earlier than in higher income level groups (p=0.04). The results of this study also showed that complementary food choices were most influenced by older members of the family and members of the mother’s immediate circle (42%) and healthcare professionals (36%). Mothers who received information about the addition of complementary food did not demonstrate a significantly different length of time devoted to exclusive breastfeeding; however, the duration of breastfeeding overall, alone and in combination with solid foods, increased (p=0.03).
Conclusion: Before the birth, families should be informed and prepared regarding the necessity of exclusive breastfeeding for the first 6 months and the continuation of breastfeeding until 2 years of age, the potential impact of relevant factors related to the type of birth, and the potentially negative effects of the use of a pacifier or bottle. All members of the family, particularly mothers and close relatives, should be advised about proper complementary feeding techniques, including the need to increase the consistency of food gradually, introducing solid foods before the 10th month, and using natural, home-cooked items instead of prepared foods. The appropriate information and guidance should be provided to all families with consideration for their education level, social environment, and life conditions.

Objectives: Congestive heart failure (CHF) is a heart disease with a growing incidence and prevalence. Creatine kinase-myocardial base (CK-MB) is generally used to determine myocardial damage; however, it is insufficiently sensitive to measure the relatively low level of myocardial damage that typically occurs in heart failure (HF). The use of cardiac troponins, which are far more sensitive and specific, has become common to identify myocardial damage and permits the detection of even minute amounts of damage. The aim of this study was to ascertain whether cardiac troponin I (cTnI) can be used to detect low-level myocardial damage occurring in CHF in real-life conditions.
Methods: Fifty patients with CHF symptoms (Group I) and 20 patients who were evaluated as normal (Group II) were included in this prospective study. The Framingham criteria were used to diagnose HF. Group I was divided into 3 subgroups according to the New York Heart Association classification of functional capacity: Class II, Group A; Class III, Group B, and Class IV, Group C. On the first day of admission, CK-MB and cTnI levels were measured and assessed quantitatively. The cTnI level was compared between these 3 subgroups and between Groups I and II. Linear regression analysis was performed to investigate the relationship between ejection fraction (EF) and cTnI.
Results: The mean cTnI value was 0.084±0.07 ng/mL in Group I and 0.018±0.012 ng/mL in Group II (p=0.0001). The mean cTnI value was 0.047±0.016 ng/mL, 0.080±0.048 ng/mL, and 0.175± 0.102 ng/mL in Groups A, B, and C, respectively. The difference between the subgroups of Group I was statistically significant. In addition, it was observed that there was a significant difference in the EF (%) value between Groups I and II and between Groups A, B, and C. Linear regression analysis revealed an inverse relationship between EF and cTnI (r: -0.66) (p=0.0001).
Conclusion: As the severity of HF increased, the cTnI serum level also increased. This increase was inversely related to the EF value. These results are consistent with other studies in the literature, suggesting that the cTnI level may be a useful marker in the diagnosis and evaluation of severity of HF.

Objectives: ST-segment elevation myocardial infarction (STEMI) complicated by respiratory failure is associated with a greater number of in-hospital and out-of-hospital adverse cardiovascular events (CVEs). The aim of this study was to analyze in-hospital outcomes and the factors affecting the outcomes of intubated patients diagnosed with STEMI who underwent primary percutaneous coronary intervention (pPCI) at a single tertiary care center.
Methods: The data of 592 patients diagnosed with acute STEMI who were admitted to the emergency department between May 2017 and January 2019 and subsequently underwent pPCI were retrospectively reviewed. Cardiovascular risk factors as well as biochemical and angiographic characteristics of patients who were intubated in the emergency room or ambulance due to cardiac arrest and those who were not intubated were compared. Adverse CVEs were defined as in-hospital death, cerebrovascular stroke, and acute stent thrombosis.
Results: A total of 60 patients (70% male; mean age: 63.6±14.0 years) who were intubated and 532 non-intubated patients (81% male; mean age: 60.2±12.1 years) were included in the study. The angiographic features of the 2 groups were similar. An adverse CVE was experienced by 43.3% of the intubated patients and 3.6% of the non-intubated patients. Multivariate analysis indicated that age (odds ratio [OR]: 1.065; p<0.001), serum lactate level (OR: 1.308; p<0.001), and left ventricle ejection fraction (OR: 0.946; p<0.001) were independent predictors of in-hospital adverse CVE in the intubated patient group.
Conclusion: The results of this single-center study showed that 1 in 10 patients hospitalized with STEMI were intubated, and approximately 4 in 10 intubated STEMI patients had an in-hospital CVE.

Objectives: The aim of the present study was to compare the effect of metoclopramide and ondansetron treatments on the emergency department observation time in acute gastroenteritis-related nausea and vomiting (NV).
Methods: The study was conducted retrospectively on 297 patients diagnosed with acute gastroenteritis in a training and research hospital's emergency service observation unit within 6 months. Patients with gastroenteritis who were diagnosed with NV were divided into two groups according to the treatment they received in the observation unit. Patients who received 4 mg ondansetron slow infusion therapy were classified as Group 1, and patients who received 10 mg metoclopramide slow infusion therapy were classified as Group 2.
Results: The average age of the patients was 39.57±18.75 years. Of the 297 participants, 56.6% (168) were female. Among them, 51.5% (153) received ondansetron (Group 1), and 48.5% (144) received metoclopramide (Group 2). 6.9% weakness–numbness and 4.9% akathisia were detected due to metoclopramide use. There were no adverse effects related to ondansetron use. The duration of observation ranged from 19 to 75 min in Group 1 and from 42 to 122 min in Group 2. Nineteen (13.2%) patients in Group 2 and 5 (3.3%) patients in Group 1 revisited the emergency department within 24 h due to ongoing complaints.
Conclusion: In conclusion, side effects of weakness and akathisia due to metoclopramide use were observed. However, no side effects were observed due to ondansetron use. Additionally, the use of ondansetron showed a shorter observation time and less recurrent admission to the emergency department. Therefore, ondansetron is a more effective drug in the treatment of NV associated with acute gastroenteritis.

The aim of this case study was to present the effect of partial pars plana vitrectomy (PPV) in two cases that is due to the presence of an intraocular foreign body (IOFB) and intraocular lens (IOL) that has dropped into the intravitreal area. The first case was a 30-year-old man with IOFB in the right eye, and the second case was a 34-year-old woman whose IOL was dropped into vitreous after trauma. In cases, IOFB and IOL were extracted from vitreous performed by partial PPV without complication. Partial PPV was effective despite without complete vitrectomy. With minimal/partial vitrectomy approach, most of the vitreous tissues was left in place. We believe that this approach will reduce the rate of complications, such as cataract and retinal detachment.

The aim of the present study was to discuss the management of anesthesia in our case with multiple sclerosis (MS) and to present the effects of sugammadex administration. A 36-year-old pregnant patient with MS disease was followed up for 6 years. She was on steroid treatment. The patient had not suffered the entire pregnancy. In addition to performing routine monitoring, “train of four” (TOF) monitorization was used. General anesthesia was given using propofol and rocuronium. At the end of the operation, muscle relaxation was reversed using sugammadex in the patient with a low TOF score. The patient was discharged on postoperative day 3. The most reliable method should be preferred in patients with MS. In patients under general anesthesia, the muscle relaxant effect is prolonged, and sugammadex can be safely used.