Inclusion Criteria:  In the case of an endotracheal tube extubation in the operating room among adult patients over the age of 18 who underwent minimally invasive cardiac surgery  Exclusion Criteria:  Emergency surgery If the patient has severe uncontrolled lung disease In case of neuromuscular block using cisatracurium and rocuronium together When neuromuscular block and reversal using cysatracurium-pyridostigmine or rocuronium-sugammadex combinations are not performed