Abstract: Objective This study aimed to investigate the effects of different doses of sugammadex sodium injection on the quality of anesthesia recovery in elderly patients undergoing radical lung cancer surgery.Methods This retrospective cohort study included 237 elderly patients who underwent radical lung cancer surgery at Ningde Municipal Hospital of Ningde Normal University from March 2021 to March 2024.All patients received rocuronium bromide for neuromuscular blockade maintenance and were divided into three groups based on sugammadex sodium injection dose:low-dose group (2 mg·kg^-1,n=80),medium-dose group (3 mg·kg^-1,n=97),and high-dose group (4 mg·kg^-1,n=60).Hemodynamic indicators,recovery quality,stress indicators,and adverse reactions were compared among the groups. Results No statistically significant differences in mean arterial pressure or heart rate were observed among the three groups at any measured time point:before sugammadex sodium injection administration,immediately after intravenous bolus injection,or at 1,5,and 10 minutes post-injection（two-sided P＞0.05）.Intergroup comparisons revealed statistically significant differences in neuromuscular blockade reversal time,recovery time from muscle relaxation,extubation time,spontaneous breathing recovery time,consciousness recovery time,and length of stay in post-anesthesia care unit.The high-dose group demonstrated shorter stay than the moderate-dose group,which in turn was shorter than the low-dose group （two-sided P＜0.05）.On postoperative day 1,malondialdehyde levels followed the trend of high-dose＜medium-dose＜low-dose,while superoxide dismutase levels showed the trend of high-dose＞medium-dose＞low-dose （two-sided P＜0.05）.The total incidence of adverse reactions differed significantly among groups （two-sided P＜0.05）,with low-dose＜medium-dose＜high-dose. Conclusion Sugammadex sodium injection at 3 mg·kg^-1 demonstrated both effective neuromuscular blockade reversal and favorable safety profile.