Rocuronium-induced generalized spontaneous movements cause pulmonary aspiration.
Rapid-sequence induction with cricoid pressure is a standard procedure for inducing anesthesia in patients with a potentially full stomach. During the induction period, if the patient develops generalized movements of the body, the pressure level of the cricoid may change unexpectedly. As a result, the increase in intragastric pressure may cause gastric regurgitation and consequent pulmonary aspiration. Rocuronium has been widely used as an alternative to succinylcholine during the induction of anesthesia. However, most patients who received rocuronium complained of severe burning pain in their arm during intravenous injection. Even after the administration of the induction agents, rocuronium injection can also cause withdrawal of the hand or other generalized movements of the body. We describe a case of gastric regurgitation with pulmonary aspiration following generalized spontaneous movements associated with rocuronium injection in a girl who received pediatric emergent surgery.
Lui
Jiin-Tarng
JT
Department of Anesthesia, Chang Gung Memorial Hospital, Taipei, ROC.
Huang
Shin-Jen
SJ
Yang
Ching-Yue
CY
Hsu
Jee-Ching
JC
Lui
Ping-Wing
PW
D000732:Androstanols / Q000008:administration & dosage / Q000009:adverse effects*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D009068:Movement; D003473:Neuromuscular Nondepolarizing Agents / Q000009:adverse effects*; D011015:Pneumonia, Aspiration / Q000209:etiology*; D000077123:Rocuronium
D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D000077123:Rocuronium