title: [Sugammadex in a man with a transplanted kidney: a case report].
abstract: We report the use of sugammadex to reverse a rocuronium block in a man who had received a kidney transplant 4 years earlier. The patient was admitted for gastric non-Hodgkins lymphoma and bleeding that required surgery. Arterial hypertension, tachycardia, and frequent ventricular extrasystoles were detected. Anesthetic induction was accomplished with propofol, fentanyl, and rocuronium; intubation was uneventful. We monitored pulse oximetry, capnography, heart rate, electrocardiography, arterial pressure (invasive), cardiac output, end-systolic volume, bispectral index, temperature, and neuromuscular function. Anesthesia was maintained with an infusion of propofol, fentanyl, and rocuronium guided by train-of-four (TOF) ratio. Total diuresis was 1100 mL. The operation lasted 4.5 hours. Recovery of neuromuscular response was spontaneous until the second TOF twitch, after which we injected 2 mg/kg of sugammadex. A TOF ratio of 0.94 was recorded 158 seconds after injection of the reversal agent. The patient was extubated without complications. Sugammadex can be used in patients with a transplanted kidney, provided the glomerular filtration rate has recovered sufficiently to allow full excretion of the sugammadex-rocuronium complex.
authors.affiliation: Hospital Clínico Quirúrgico "Hermanos Ameijeiras", Ciudad de La Habana, Cuba. ice@infomed.sld.cu
authors.forename: I
authors.initials: I
authors.lastname: Cordero Escobar
authors.forename: B
authors.initials: B
authors.lastname: Rey Martínez
authors.forename: R
authors.initials: R
authors.lastname: Company Teuler
authors.forename: A
authors.initials: A
authors.lastname: Pérez Carbonell
mesh_terms: D000328:Adult; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D019148:Neuromuscular Blockade; D000077122:Sugammadex; D047408:gamma-Cyclodextrins / Q000627:therapeutic use*
chemical_list: D047408:gamma-Cyclodextrins; D000077122:Sugammadex