title: Three cases of suspected sugammadex-induced hypersensitivity reactions.
abstract: Neuromuscular blocking agents have been implicated in 60-70% of anaphylactic events associated with anaesthesia. We report two cases of probable hypersensitivity reaction to sugammadex and an additional suspected but less supported case of possible immune-mediated reaction or other adverse reaction. The patients were given a bolus of sugammadex 100 mg immediately before extubation. In all three patients, a possible allergic reaction was suspected within 4 min of sugammadex administration, but with different degrees of severity. Skin testing was positive in two of these patients. Hypersensitivity to sugammadex unaccompanied by cardiovascular or respiratory symptoms might be missed during the course of anaesthesia. Careful monitoring for possible allergic responses is required in patients who have received sugammadex.
authors.affiliation: Department of Anaesthesiology and Critical Care Medicine, Graduate School of Medical and Dental Sciences,  Kagoshima University,  8-35-1 Sakuragaoka, Kagoshima 890-8520,  Japan.
authors.forename: K
authors.initials: K
authors.lastname: Godai
authors.forename: M
authors.initials: M
authors.lastname: Hasegawa-Moriyama
authors.forename: T
authors.initials: T
authors.lastname: Kuniyoshi
authors.forename: T
authors.initials: T
authors.lastname: Kakoi
authors.forename: K
authors.initials: K
authors.lastname: Ikoma
authors.forename: S
authors.initials: S
authors.lastname: Isowaki
authors.forename: A
authors.initials: A
authors.lastname: Matsunaga
authors.forename: Y
authors.initials: Y
authors.lastname: Kanmura
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D000732:Androstanols / Q000037:antagonists & inhibitors; D000768:Anesthesia, General / Q000379:methods; D004342:Drug Hypersensitivity / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D003473:Neuromuscular Nondepolarizing Agents / Q000037:antagonists & inhibitors; D000077123:Rocuronium; D012882:Skin Tests; D000077122:Sugammadex; D047408:gamma-Cyclodextrins / Q000009:adverse effects* / Q000494:pharmacology
chemical_list: D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D047408:gamma-Cyclodextrins; D000077122:Sugammadex; D000077123:Rocuronium