Is there still an indication for the use of succinylcholine in cesarean section? The answer is no

Carlos, Ricardo Vieira; Torres, Marcelo Luís Abramides; Boer, Hans D. de

doi:10.1016/j.bjane.2016.09.011

Cited by 1 publication

(1 citation statement)

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“…Succinylcholine remains the neuromuscular blocking drug of choice for obstetric anesthesia because of its rapid onset and short duration of action [26]. Recently, it has been suggested that the use of a combination of rocuronium and sugammadex can increase the safety and quality of care in obstetric patients; thus, the use of succinylcholine in C-sections might no longer be indicated [27].…”

Section: Discussionmentioning

confidence: 99%

Prolonged neuromuscular blockade and insufficient reversal after sugammadex administration in cesarean section under general anesthesia: a case report

Moriwaki

Kayashima

2019

JA Clin Rep

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Background: We present a rare case of prolonged neuromuscular blockade and insufficient reversal after sugammadex administration in a pregnant patient being treated with magnesium sulfate and nifedipine undergoing cesarean section under general anesthesia. Case presentation: A 37-year-old woman at 34 weeks gestation, weighing 42.5 kg, and receiving magnesium sulfate 94 mg/kg for preeclampsia and nifedipine 20 mg, underwent cesarean section under general anesthesia for abruptio placentae. Her trachea was intubated after administering rocuronium 0.94 mg/kg. Postoperatively, sugammadex 4.7 mg/kg was administered at post-tetanic count 2, 163 min after rocuronium administration. However, 9 min after sugammadex administration, the train-of-four ratio only reached 0.7. Fifteen min after sugammadex administration, extubation was successfully performed when the train-of-four ratio reached 0.9 after administration of atropine 0.5 mg and neostigmine 1.0 mg. Conclusions: Caution is required in pregnant women on high-dose magnesium sulfate with nifedipine, which may cause prolongation of neuromuscular blockade and insufficient reversal.

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Section: Discussionmentioning

confidence: 99%