Sugammadex-induced bronchospasm during desflurane anaesthesia

Baronos, Stamatis; Selvaraj, Bright Jebaraj; Liang, Meichang; Ahmed, K Hamzah; Yarmush, Joel

doi:10.1016/j.bja.2019.04.001

Cited by 13 publications

(9 citation statements)

References 3 publications

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“…In our cohort 6 patients were administered supplementary bronchodilator medication and bronchospasm was documented in 3 patients. While sugammadex has also been associated with respiratory complications 21 , in the current study bronchospasm was only documented in patients with obstructive respiratory disease diagnosed prior to the ICU admission who underwent airway instrumentation.…”

Section: Discussionmentioning

confidence: 78%

A retrospective study of sugammadex for reversal of neuromuscular blockade induced by rocuronium in critically ill patients in the ICU

Bologheanu

Lichtenegger

Maleczek

et al. 2022

Sci Rep

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Sugammadex has been approved for reversal of neuromuscular blockade by vecuronium and rocuronium in adults undergoing surgery. Although widely used in the operating room, sugammadex has not been investigated in the intensive care unit setting. This study aimed to evaluate the use of sugammadex in critically ill patients with a focus on known drug-related adverse reactions. In this single-center, retrospective, observational study, 91 critically ill patients who were administered sugammadex while in the ICU were evaluated. Electronic health records were reviewed, and baseline data, as well as indication and incidence of complications possibly related to sugammadex, were retrospectively collected. The most common procedures requiring neuromuscular blockade followed by reversal with sugammadex were bronchoscopy, percutaneous dilatative tracheostomy, and percutaneous endoscopic gastrostomy. Within 2 h following administration of sugammadex, skin rash and use of antihistamines were reported in 4 patients (4.4%) in total; bradycardia was observed in 9 patients (9.9%), and respiratory adverse events were described in 3 patients (3.3%). New-onset bleeding up to 24 h after sugammadex was reported in 7 patients (7.7%), 3of whom received transfusions of packed red blood cells. Sugammadex was well tolerated in critically ill patients and could be considered for reversal of neuromuscular blockade in this population. Larger prospective studies are required to determine the safety profile and evaluate the potential benefit and indications of sugammadex in the critical care setting.

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Section: Discussionmentioning

confidence: 78%

A retrospective study of sugammadex for reversal of neuromuscular blockade induced by rocuronium in critically ill patients in the ICU

Bologheanu

Lichtenegger

Maleczek

et al. 2022

Sci Rep

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“…Similarly, incidences of bronchospasm after sugammadex injection during desflurane anesthesia have also been reported. 10 , 11 The impact mechanism of sugammadex does not involve interaction with the cholinergic system. It has also been shown not to affect the contractility of the bronchial smooth muscle of the rat.…”

Section: Discussionmentioning

confidence: 99%

Reversal of Rocuronium-Induced Neuromuscular Blockade by Sugammadex Under Sevoflurane and Desflurane Anesthesia in Children

2023

Eurasian J Med

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Objective: In children, neuromuscular blockers may have different effects with various inhalation agents and incomplete reversal of the blockade continues to be a problem. The aim of the study is to observe the effects of sugammadex on reversing the blockade by a single dose of rocuronium, the peak inspiratory pressure, hemodynamic parameters in children under sevoflurane and desflurane anesthesia. Materials and Methods: One hundred forty-eight children aged 2-10 years old, to be operated under short-term general anesthesia, were enrolled in this prospective randomized controlled trial. After induction, the patients were intubated at the end of TOF (Train-of-four) ratio of 1.0-0. The time taken until TOF reached 0.25 was recorded, and 2 mg/kg sugammadex was administered to the patients. The period until the TOF was at least 0.9 and in the first 10 minutes after sugammadex injection, peak inspiratory pressure, the systolic-diastolic arterial pressure, and the heart rate wers3e monitored and possible side effects were observed in the recovery room. Results: Following the injection of sugammadex, the time taken for TOF of 0.25 to reach > 0.9 was significantly shorter in the 2-4-year-old age group under sevoflurane anesthesia. After sugammadex injection, a small but statistically significant increase in peak inspiratory pressure values was observed in Group D at the 2nd, 5th, and 10th minutes. Conclusion: Rapid and complete recovery was achieved from the block induced by a single dose of 0.6 mg/kg rocuronium by the use of sugammadex which did not give rise to any side effects.

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“…In addition, rocuronium and sugammadex can only be in reactions affecting the lungs. 12,23 For these reasons, we think that the results of this study are more important.…”

Section: A B D Cmentioning

confidence: 92%

Does sugammadex suppress allergic inflammation due to rocuronium in animal model of rat?

Yeşiltaş

Orhon

Cakır

et al. 2021

aei

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Introduction and Objectives: There are a few reports in the literature about the successful use of sugammadex in the treatment of hypersensitivity reactions caused by rocuronium; however, the pathophysiological mechanism is still unknown. This study aims to investigate the changes caused by rocuronium in the lung and the effect of sugammadex on these changes with bio-chemical, light microscopic and immunohistochemical parameters on a rat model.Materials and Methods: For the study, 28-male Sprague-Dawley rats were randomly divided, seven of each, into four groups. Group C (control) received only 0. 9 % NaCl without any drug. Group R received rocuronium alone 1mg/kg. Group S received sugammadex alone 96 mg/kg. Group RS received rocuronium 1mg/kg and sugammadex 96 mg/kg. After 24 h later, the ani-mals were sacrificed and their tissues were removed. Biochemical (IgE/CRP), light microscopic and immunohistochemical findings were recorded.Results: Immunoglobulin E and CRP levels, peribronchial, alveolar septal lymphocytic infiltra-tion, thickening of the alveolar membranes and bleeding sites in Group R were significantly higher than all the other groups. In Group RS, while these parameters were significantly lower than that of Group R and Group S, it was significantly higher than that of Group C. Total mast cells and tryptase-positive mast cells counts were significantly higher in Group R than in all other groups. In Group RS, these parameters were statistically lower than that of Group R and Group S, but higher than that of Group C.Conclusions: This study shows that allergic inflammatory changes due to rocuronium in the lungs of rats are reduced with sugammadex. These results support cases of anaphylaxis due to rocuronium which improved with sugammadex.

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Sugammadex-induced bronchospasm during desflurane anaesthesia

Cited by 13 publications

References 3 publications

A retrospective study of sugammadex for reversal of neuromuscular blockade induced by rocuronium in critically ill patients in the ICU

A retrospective study of sugammadex for reversal of neuromuscular blockade induced by rocuronium in critically ill patients in the ICU

Reversal of Rocuronium-Induced Neuromuscular Blockade by Sugammadex Under Sevoflurane and Desflurane Anesthesia in Children

Does sugammadex suppress allergic inflammation due to rocuronium in animal model of rat?

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