title: Sugammadex in the management of rocuronium-induced anaphylaxis.
abstract: Anaphylaxis during anaesthesia is a rare event that in ∼60-70% of cases is secondary to neuromuscular blocking agents. It has been suggested previously that the recent introduction of sugammadex may provide a novel therapeutic approach to the management of rocuronium-induced anaphylaxis. We describe the case of a 33-yr-old female who suffered a severe anaphylactic reaction to rocuronium, presenting with cardiovascular collapse on induction of anaesthesia. After 19 min of traditional management, she was given a bolus of sugammadex 500 mg. This was associated with an improvement in the adverse haemodynamic state. The underlying reasons for this are unclear, but sugammadex may potentially be a useful adjunct in the management of rocuronium-induced anaphylaxis.
authors.affiliation: School of Women's and Infants' Health, University of Western Australia, Australia. nolan.mcdonnell@health.wa.gov.au
authors.forename: N J
authors.initials: NJ
authors.lastname: McDonnell
authors.forename: T J G
authors.initials: TJ
authors.lastname: Pavy
authors.forename: L K
authors.initials: LK
authors.lastname: Green
authors.forename: P R
authors.initials: PR
authors.lastname: Platt
mesh_terms: D000328:Adult; D000707:Anaphylaxis / Q000139:chemically induced / Q000188:drug therapy* / Q000503:physiopathology; D000732:Androstanols / Q000009:adverse effects*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D003473:Neuromuscular Nondepolarizing Agents / Q000009:adverse effects*; D000077123:Rocuronium; D000077122:Sugammadex; D047408:gamma-Cyclodextrins / Q000627:therapeutic use*
chemical_list: D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D047408:gamma-Cyclodextrins; D000077122:Sugammadex; D000077123:Rocuronium