Suboptimal reversal of neuromuscular blockage after surgery is possibly related to unfavorable postoperative respiratory conditions and elevated pain levels. Rapid and complete reversal of neuromuscular block was not possible untill sugammadex was discovered. The investigators hyposthesise that reversal with sugammadex leads to favorable postoperative respiratory conditions and less pain compared to reversal with neostigmine.

Inclusion Criteria:

• Age 18 years

• - BMI < 35

• -ASA class I- III

• -Patients scheduled for surgery requiring general anesthesia with the use of NMBA's

  • Patients with ability to give oral and written informed consent

Exclusion Criteria:

• Failure to meet the inclusion criteria

  • -Known or suspected neuromuscular disorders impairing neuromuscular function
  • -Allergies to muscle relaxants, anesthetics or narcotics

• A (family) history of malignant hyperthermia

  • -Women who are or may be pregnant or are currently breast feeding
  • -Contraindications for the use of neostigmine

• Intestinal obstruction,

• COPD GOLD 4

  • -Abnormal heart rhythm (eg. bradycardia: < 40/min);
  • -Surgery requiring neuraxial anesthesia / analgesia
  • -Preoperative cognitive dysfunction or mental disabilities
  • -Preexistent significant pulmonary disease with preoperative SpO2 < 90%
  • -Preoperative ICU treatment / intubation (ICU patient);
  • -Need for postoperative ICU treatment or ventilation;