Emergency Use of Sugammadex After Failure of Standard Reversal Drugs

Abstract

Administration of sugammadex, 350 mg IV (4 mg/kg), in the postanesthesia care unit immediately (<60 s) relieved acute respiratory distress due to residual neuromuscular blockade in a 42-yr-old patient with chronic renal failure who had received vecuronium, 10 mg IV, for tracheal intubation, after inadequate reversal of neuromuscular blockade in the operating room with neostigmine, 5 mg IV, and glycopyrrolate, 1 mg IV.

Sugammadex: A Review of Neuromuscular Blockade Reversal

“…4.1 and 4.2). Sugammadex may also have potential for the rescue of residual neuromuscular blockade if reversal with an AChE inhibitor is incomplete [69,70], and low-dose sugammadex (i.e. \2 mg/kg) successfully reversed shallow, residual, rocuronium-induced neuromuscular blockade [71][72][73].…”

Neostigminin başarısız olduğu roküronyuma bağlı rezidüel kürarizasyonda sugammadeks kullanımı

“…Lenz ve ark. [11] 10 mg veküronyum kullandıkları kronik böbrek yetmezliği hastasında nöromusküler bloğu antagonize etmek için 5 mg neostigmin ve 1 mg glikopirolat kullanmalarına rağmen bloğu tam olarak antagonize edememişler ve hastada rezidüel nörömusküler bloğa bağlı akut solunum yetmezliği gelişmiştir. Hastaya 350 mg IV sugammadeks (4mg/ kg) uygulandıktan 60 sn sonra tidal volüm düzelmiş, 2 dk sonra ise trakeal ekstübasyon uygulanmıştır.…”

Sugammadex: the first selective binding reversal agent for neuromuscular block

“…In a case report, Lenz et al [62] demonstrated the successful administration of sugammadex in the PACU when neostigmine failed to reverse a vecuronium-induced block. This event suggested the possible use of sugammadex as a "rescue" medication for partial paralysis and residual NMB.…”