Comparison of Two Quantitative EMG Monitors for Deep Neuromuscular Block in Laparoscopic/Robotic and VATS Surgery

Inclusion Criteria: * Adult male or female patients aged ≥ 18 years old. * Patients undergo elective abdominal laparoscopic/robotic or thoracic video-assisted (VAT) surgeries requiring general anesthesia for greater than 3 hours at The Ohio State University Wexner Medical Center. * Able to provide a signed, written informed consent. * Able to speak, read, and write in English. * ASA physical status I-III. Exclusion Criteria: * Patients who require emergency surgery or an emergent intervention. * Any documented cognitive or psychological disorders that, in the investigator's opinion, can interfere with the patient's pain perception. * Vulnerable populations: pregnant females, prisoners, breastfeeding. * Presence of any medical condition that, in the opinion of the principal investigator, should exclude the patient from the study (patients with pre-existing neuromuscular diseases. * Allergy or contraindications to any of the anesthetics, NMB agents, or sugammadex. * Patients with anatomical abnormalities of the hands or arms that prevent proper placement of the sensors for nerve stimulation. * Limited access to the monitoring area due to surgical positioning. * Patients with peripheral vascular disease, since it may affect measurement accuracy.