Inclusion Criteria:  Inclusion criteria: 40 and 65 years of age, American Society of Anesthesiologists Physical Status (ASA-PS) of 3 and 4, Elective lower gastrointestinal tumor resection surgeries, Supine positioning, Surgery requiring use of general anesthesia and muscle relaxation, Use of inhalational agent of sevoflurane anesthesia, Surgical duration of about three to six hours.  Exclusion Criteria:  History of known or suspected neuromuscular disease, History of renal or hepatic dysfunction, Hyperkalemia, Patients receiving antibiotics, anticonvulsants, or magnesium, History of stroke, History of glaucoma, History of pregnancy or breastfeeding, Suspicion of abdominal infection or sepsis, Suspected history of malignant hyperthermia, An allergy to medications used during general anesthesia