Hypersensitivity reaction probably induced by sugammadex

Abstract

We report here an intellectually compromised 7-year-old boy with cerebral palsy who developed a hypersensitivity reaction several minutes after the administration of sugammadex for subsequent extubation. He developed signs of upper airway stenosis and decreased oxygen saturation, as well as wheals on his neck, chest, and both upper extremities. He was successfully treated with immediate administration of adrenaline and hydrocortisone. A hypersensitivity reaction to sugammadex was suspected on the basis of the patient's clinical course.

Comparison of Decurarization Using Sugammadex and Neostigmine After Rocuronium During Desflurane Anesthesia

“…Some other studies reported hypersensitivity and anaphlaxis during sugammadex use [18][19][20][21] . In addition, a bitter taste and coughing due to the high dose of the drug were also reported.…”

Association between sugammadex and anaphylaxis in pediatric patients: A nested case‐control study using a national inpatient database

“…Some reports described sugammadex‐induced anaphylactic reactions in adults . A previous study reported that incidence proportion of sugammadex‐induced anaphylactic reactions was estimated to be 0.003% .…”

“…However, the data were obtained from anesthesiologists on a voluntary basis, and may have been underreported. Regarding pediatric patients, only a few small studies have reported anaphylaxis after sugammadex administration …”

“…[1][2][3] Some reports described sugammadex-induced anaphylactic reactions in adults. [4][5][6][7][8][9][10] A previous study reported that incidence Accepted: 24 April 2018 DOI: 10.1111/pan.13401 proportion of sugammadex-induced anaphylactic reactions was estimated to be 0.003%. 7 However, the data were obtained from anesthesiologists on a voluntary basis, and may have been underreported.…”

“…Regarding pediatric patients, only a few small studies have reported anaphylaxis after sugammadex administration. 3,5,7 In the present study, we examined the association between sugammadex and anaphylaxis in pediatric patients who underwent general anesthesia, using a national inpatient database in Japan. Our hypothesis was that sugammadex is associated with perioperative anaphylaxis.…”