Anesth Pain Med.  2021 Jan;16(1):56-59. 10.17085/apm.20074.

Treatment of rocuronium-induced anaphylaxis using sugammadex - A case report -

• Kim SM
• Oh Sh
• Ryu SA

• KMID: 2512282
• DOI: http://doi.org/10.17085/apm.20074

Abstract

Background
Perioperative anaphylaxis is a life-threatening clinical condition characterized by severe respiratory and cardiovascular manifestations. Neuromuscular blocking agents are the most common cause of anaphylaxis during anesthesia. Case: We report a case of rocuronium-induced anaphylaxis treated with sugammadex. A 75–year-old woman was scheduled to undergo spinal surgery. She had no history of allergies. After the injection of rocuronium, she developed hypotension and tachycardia, and skin rashes and urticaria appeared. The patient received sugammadex to delay the operation, and her vital signs were stabilized. On the 76th postoperative day, we performed intradermal tests for rocuronium, propofol, and cefazolin. Diluted rocuronium alone induced 14 mm of flare and 8 mm of wheal within 5 min, both of which disappeared within 15 min after the intradermal injection.
Conclusions
Sugammadex is a useful rocuronium antagonist that can be used to treat rocuronium-induced anaphylaxis.

Keyword

Anaphylaxis; Anesthesia; Rocuronium; Sugammadex; Shock; Treatment

Figure

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  Fig. 1. Chart showing the vital sign changes. HR: heart rate, SBP: systolic arterial blood pressure, DBP: diastolic arterial blood pressure. *Rocuronium injection and intubation. †Epinephrine. ‡Sugammadex intravenous injection.

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