Study of Recovery of Strength After Surgery Comparing Two Different Medications for Reversal of Muscle Relaxant

Inclusion Criteria:

- Adult patients age 18 years of age or greater who are capable of giving consent

- Undergoing surgical procedures of expected length 6
Exclusion Criteria:

- Pregnancy

- History of documented anaphylaxis or contraindication to any of the study medications

- Active coronary disease with a positive cardiac stress test

- History of severe chronic obstructive pulmonary disease (COPD) defined as an FEV1 <
50% of predicted

- Serum Creatinine >/= 2.0 mg/dL

- Severe hepatic dysfunction accompanied by coagulopathy

- Definition:

- Known liver Disease AND

- INR > 1.5 (except for patients on anticoagulants) AND

- Platelet count <100,00/ul without other obvious cause

- Chronic sustained release opioid for > 2 weeks duration pre op (in the 30 days prior
to surgery)

- Use of toremifene

- Significant cognitive impairment or documented psychologic impairment

- Myasthenia gravis or other neuromuscular disease

- Patients who are not eligible for standard anesthetic induction, eg, those needing
rapid sequence induction or awake fiberoptic bronchial intubation.

- American Society of Anesthesiologists (ASA) Status > 3