Sugammadex associate persistant bradycardia

Bilgi, Murat; Demırhan, Abdullah; Akkaya, Akçan; Tekelioğlu, Ümit Yaşar; Koçoğlu, Hasan

doi:10.5455/ijmsph.2013.251220131

Cited by 21 publications

(34 citation statements)

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“…In this case, approximately 4 min after sugammadex administration, the patient's heart rate decreased to 36 bpm accompanied by severe hypotension, which was unresponsive to intravenous atropine but recovered with intravenous adrenaline. Some case reports have described severe bradycardia associated with sugammadex [4][5][6][7][8][9]. Sugammadex-induced bradycardia is not due to cholinergic effects as it has been noted even in a patient with a denervated, transplanted heart [8]; however, no other mechanism has been postulated.…”

Section: Discussionmentioning

confidence: 99%

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A rare case of atropine-resistant bradycardia following sugammadex administration

et al. 2020

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Background: Profound bradycardia caused by sugammadex has been reported, although its mechanism is unclear. Herein, we suggest a possible culprit for this phenomenon. Case presentation: A 50-year-old woman without comorbidity except mild obesity underwent a transabdominal hysterectomy and right salpingo-oophorectomy. After surgery, sugammadex 200 mg was intravenously administered. Approximately 4 min later, her heart rate decreased to 36 bpm accompanied by hypotension (41/20 mmHg) and ST depression in limb lead electrocardiogram (ECG). Atropine 0.5 mg was injected intravenously without improving the hemodynamics. Intravenous adrenaline 0.5 mg was added despite the lack of signs suggesting allergic reactions. Her heart rate and blood pressure quickly recovered and remained stable thereafter, although 12-lead ECG taken 1 h later still showed ST depression. Conclusions: In this case, the significant bradycardia appeared attributable to coronary vasospasm (Kounis syndrome) induced by sugammadex, considering the ECG findings and high incidence of anaphylaxis due to sugammadex.

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Section: Discussionmentioning

confidence: 99%

“…However, the incidence of sugammadex-induced anaphylaxis is relatively high [3]. In addition, several case reports have described profound bradycardia, even cardiac arrest, possibly caused by sugammadex administration, although the mechanism of this rare adverse event has remained unclear [4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

A rare case of atropine-resistant bradycardia following sugammadex administration

et al. 2020

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“…Sugammadex is another option in this patients and has been used in some cases safely but there have been case reports which caused persistent bradycardia and arrthymia. 7,8 So we avoided both of the agents by TOF monitoring, following a TOF value of 0.9 the patient was extubated safely and no recurarization was observed in the post anesthesia care unit (PACU).…”

Section: Discussionmentioning

confidence: 99%

Normalization of Electrocardiography Pattern Due to Anesthesia in a Patient with Wolff-Parkinson-White Syndrome During Non-Cardiac Surgery

Sabuncu¹,

Yağar²,

Yomen³

2018

Turkiye Klinikleri J Cardiovasc Sci

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“…No mechanism has been postulated for this response. Bilgi et al 13 reported a sinusoidal bradycardia resistant to atropine in a 56-year-old, 77-kg adult man without associated comorbidities who was undergoing ureterorenoscopy. At the completion of the surgical procedure sugammadex (200 mg) was administered intravenously.…”

Section: Discussionmentioning

confidence: 99%

Bradycardia in a Pediatric Heart Transplant Recipient: Is It the Sugammadex?

King

Naguib

Tobias

2017

The Journal of Pediatric Pharmacology and Therapeutics

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Sugammadex is a novel pharmacologic agent that is used to selectively reverse the effects of the neuromuscular blocking agents rocuronium and vecuronium. Various advantages have been reported when comparing its reversal of neuromuscular blockade to that achieved with acetylcholinesterase inhibitors (neostigmine). In heart transplant recipients, bradycardia may occur following the administration of acetylcholinesterase inhibitors, due to the denervation of the heart. Theoretically, the combination of rocuronium and sugammadex could be advantageous in this clinical scenario to avoid the potential bradycardia resulting from neostigmine administration. We present a 10-year-old male who developed profound bradycardia immediately following the administration of intravenous sugammadex. The options for reversal of neuromuscular blockade in heart transplant recipients is discussed, previous reports of bradycardia following sugammadex are presented, and the role of sugammadex in the bradycardia in our patient is reviewed.

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Sugammadex associate persistant bradycardia

Cited by 21 publications

References 0 publications

A rare case of atropine-resistant bradycardia following sugammadex administration

A rare case of atropine-resistant bradycardia following sugammadex administration

Normalization of Electrocardiography Pattern Due to Anesthesia in a Patient with Wolff-Parkinson-White Syndrome During Non-Cardiac Surgery

Bradycardia in a Pediatric Heart Transplant Recipient: Is It the Sugammadex?

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