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 female 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.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7861895 | PMC |
http://dx.doi.org/10.17085/apm.20074 | DOI Listing |
Sci Transl Med
September 2024
Institut Pasteur, Université Paris Cité, INSERM UMR1222, Antibodies in Therapy and Pathology, 75015 Paris, France.
Br J Anaesth
April 2024
Department of Anesthesiology, The Jikei University School of Medicine, Tokyo, Japan. Electronic address:
Rocuronium, a nondepolarizing neuromuscular blocking agent used for muscle relaxation especially during endotracheal intubation, can cause hypersensitivity reactions. This article provides an overview of anaphylactic reactions; risk factors; and the pathophysiology, presentation, diagnosis, treatment, and nursing implications associated with rocuronium-induced anaphylaxis. Life-threatening anaphylaxis can be immunoglobulin E-mediated or non-immunoglobulin E-mediated and usually occurs after the first dose.
View Article and Find Full Text PDFJ Clin Med
November 2022
Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu 610041, China.
This current phase II clinical trial was to compare the effect and safety of adamgammadex, a new cyclodextrin-based selective relaxant binding agent, with sugammadex to reverse rocuronium-induced neuromuscular block. Patients were randomised to receive adamgammadex (4 or 6 mg kg) or sugammadex (2 mg kg, as a positive control group) at the reappearance of the second twitch (T) in response to TOF stimulation. The standard safety data were collected.
View Article and Find Full Text PDFJ Int Med Res
July 2022
Department of Anaesthesiology, New Taipei Municipal TuCheng Hospital (Built and Operated by Chang Gung Medical Foundation), New Taipei City, Taiwan.
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