title: [Anesthetic management for electroconvulsive therapy using rocuronium bromide and sugammadex sodium in a patient with suspected malignant syndrome].
abstract: A 62-year-old woman was treated for schizophrenia for 40 years. When the symptoms had deteriorated and new medications had to be added, CPK rose and she malignant syndrome was suspected. The electroconvulsive therapy (ECT) was proposed because of no improvement of the symptoms. We employed rocuronium bromide instead of suxamethonium considering malignant syndrome. The maintenance of anesthesia was necessary, because the duration of rocuronium bromide is longer than that of suxamethonium chloride. Anesthesia was induced and maintained using target controlled infusion (TCI) of propofol. After ECT was performed, sugammadex sodium 4 mg . kg-1 was administered at 2 post-tetanic counts (PTC) and the patient could come out the operating room safely and speedy. ECT using rocuronium bromide and sugammadex sodium can be performed safely and speedily, when suxamethonium chloride cannot be used.
authors.affiliation: Department of Anesthesiology, Juntendo University Urayasu Hospital, Urayasu 279-0021.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Maeda
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Enomoto
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Kamiyama
authors.forename: Eiichi
authors.initials: E
authors.lastname: Inada
mesh_terms: D000732:Androstanols / Q000008:administration & dosage* / Q000037:antagonists & inhibitors; D000768:Anesthesia, General; D004565:Electroconvulsive Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009459:Neuroleptic Malignant Syndrome / Q000628:therapy*; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage*; D000077123:Rocuronium; D000077122:Sugammadex; D047408:gamma-Cyclodextrins / Q000008:administration & dosage* / Q000494:pharmacology
chemical_list: D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D047408:gamma-Cyclodextrins; D000077122:Sugammadex; D000077123:Rocuronium