title: [Case of anaphylactic reaction caused by sugammadex].
abstract: A 17-year-old man was scheduled for ventriculo-peritoneal shunt under general anesthesia. Anesthesia was induced by propofol, rocuronium and pentazocine, and maintained with sevoflurane and nitrous oxide. The operation was finished in 1 hour and 4 minutes without trouble. After the operation, sugammadex was administered. After about 2 minutes, the redness and the wheal appeared in the body trunk, and SpO2 dropped to The appearance of rapid symptom immediately after administration of sugammadex indicated that anaphylactic reaction had occurred. We administered adrenaline. After the administration of adrenaline several times, cutaneous findings became improved and SpO2 was stabilized. We started continuous infusion of adrenaline, and the patient was moved to the intensive care unit (ICU). Twelve hours after entering the ICU, the patient was extubated. He showed no troubles thereafter, and left hospital. After introduction of sugammadex to clinical use, 7 cases of anaphylactic reaction to sugammadex were reported. We must know that anaphylactic reaction can be induced by sugammadex.
authors.affiliation: Division of Anesthesiology and Perioperative Medicine, Kobe University Graduate School of Medicine, Kobe.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Motoyama
authors.forename: Shinichirou
authors.initials: S
authors.lastname: Izuta
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Maekawa
authors.forename: Riichiro
authors.initials: R
authors.lastname: Chuma
mesh_terms: D000293:Adolescent; D000707:Anaphylaxis / Q000139:chemically induced* / Q000188:drug therapy; D000732:Androstanols / Q000037:antagonists & inhibitors; D000768:Anesthesia, General; D004837:Epinephrine / Q000008:administration & dosage; D006801:Humans; D008297:Male; D003473:Neuromuscular Nondepolarizing Agents / Q000037:antagonists & inhibitors; D011182:Postoperative Care; D000077123:Rocuronium; D000077122:Sugammadex; D016896:Treatment Outcome; D017287:Ventriculoperitoneal Shunt; D047408:gamma-Cyclodextrins / Q000009:adverse effects* / Q000494:pharmacology
chemical_list: D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D047408:gamma-Cyclodextrins; D000077122:Sugammadex; D000077123:Rocuronium; D004837:Epinephrine