The Use of Sugammadex in a Patient With Guillain–Barre Syndrome

Abstract

Sugammadex encapsulates and inactivates rocuronium and vecuronium. It is used to reverse neuromuscular blockade from these nondepolarizing agents. The safety of sugammadex in patients with neuromuscular disease has not been established. Guillain-Barre Syndrome (GBS) is a neuromuscular disease characterized by acute inflammatory polyneuropathy. Patients with GBS may exhibit autonomic dysfunction, chronic pain, abnormal reactions to neuromuscular blocking agents, and may require postoperative mechanical ventilation. We report the successful use of sugammadex to reverse rocuronium in a patient with chronic GBS, who presented for a hemicolectomy.

Anesthetic management of a patient with chronic inflammatory demyelinating polyneuropathy by combination of total intravenous and regional anesthesia

“…In fact, Hara and colleagues reported prolonged effects of vecuronium in a patient with CIPD undergoing partial gastrectomy [4]. However, Maruyama and colleagues reported the safe use of rocuronium with sugammadex for reversal while monitoring muscle relaxation in three patients with CIPD [5], and Tezcan and colleagues used sugammadex successfully to reverse rocuronium in a patient with Guillain-Barre syndrome (GBS), which is a disease similar to CIPD [6]. Hence, muscle relaxant reversals with sugammadex may be safely used in patients with CIPD.…”

Anesthetic Care of a Child With Acute Flaccid Myelitis

“…As our patient would receive postoperative mechanical ventilation, neuromuscular blockade was established with rocuronium, a non-depolarizing muscle relaxant. With pre-existing hypotonia and weakness, the effects of rocuronium can be expected to be prolonged; however, the novel agent, sugammadex, offers an option for rapid reversal of neuromuscular blockade with rocuronium and a limited chance of residual weakness even in patients with comorbid neuromuscular conditions [ 18 , 19 ].…”