title: Reversal of profound neuromuscular blockade with sugammadex after failure of rapid sequence endotracheal intubation: a case report.
abstract: OBJECTIVE
  Sugammadex is a reversal agent that acts as a selective antagonist of neuromuscular blockade induced by rocuronium and vecuronium. This is a case report of an elderly female patient who had sugammadex just after rocuronium induction.
  
  
  METHODS
  An 88-year-old female patient, 34 kg, presented a femoral fracture and had to undergo general anesthesia after spinal anesthesia failure. Induction was performed with propofol 1.5mg.kg(-1), rocuronium 1.2mg.kg(-1), fentanyl 100 mcg, and lidocaine 2mg.kg(-1). There was no success in either tracheal intubation or laryngeal mask positioning maneuvers. The use of sugammadex at a dose of 16 mg.kg(-1) was required and respiratory function returned to normal.
  
  
  CONCLUSIONS
  Literature recommends sugammadex at a dose of 16 mg.kg(-1) for patients with profound blockade. It was used in our patient with rapid and effective reversal of neuromuscular blockade allowing the patient to undergo another procedure to ensure the airway patency without clinical impairment of her general condition.
authors.affiliation: Universidade Federal de Alagoas, Av. Lourival Melo Mota S/N, Tabuleiro do Martins, Maceió, AL, Brazil. fabianotimbo@yahoo.com.br
authors.forename: Fabiano Timbó
authors.initials: FT
authors.lastname: Barbosa
authors.forename: Rafael Martins
authors.initials: RM
authors.lastname: da Cunha
mesh_terms: D000369:Aged, 80 and over; D000732:Androstanols / Q000037:antagonists & inhibitors; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods; D019148:Neuromuscular Blockade / Q000379:methods*; D003473:Neuromuscular Nondepolarizing Agents / Q000037:antagonists & inhibitors; D000077123:Rocuronium; D000077122:Sugammadex; D017211:Treatment Failure; D047408:gamma-Cyclodextrins / Q000627:therapeutic use*
chemical_list: D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D047408:gamma-Cyclodextrins; D000077122:Sugammadex; D000077123:Rocuronium