title: [Difficult ventilation after sugammadex administration: a case report].
abstract: A 71-year-old woman was scheduled for arthroscopic knee surgery. Anesthesia was administered with sevoflurane, fentanyl, and rocuronium bromide. Total dose of fentanyl was 200 microg and total dose of rocuronium bromide was 40mg. After surgery sugammadex 150 mg was given before awakening of the patient and appearance of spontaneous breathing. Immediately after the administration of sugammadex airway pressure increased to 37 cmH20, and ventilation became difficult. After naloxone 0.1 mg injection, ventilation improved dramatically. The cause of difficult ventilation was surmised to be upper airway reflex or muscle rigidity caused by reaction to fentanyl. We thought the phenomenon was clearly manifested by rapid recovery from muscle relaxation by injection of sugammadex. Before injection of sugammadex, it is necessary to confirm the effects of anesthetics on the patient's condition.
authors.affiliation: Department of Anesthesia, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Hasegawa
authors.forename: Masaharu
authors.initials: M
authors.lastname: Kinoshita
authors.forename: Takehisa
authors.initials: T
authors.lastname: Asahi
mesh_terms: D000368:Aged; D000403:Airway Resistance; D000732:Androstanols / Q000037:antagonists & inhibitors; D000762:Anesthesia Recovery Period; D000777:Anesthetics / Q000009:adverse effects; D001182:Arthroscopy; D005260:Female; D006801:Humans; D008592:Menisci, Tibial / Q000601:surgery; D003473:Neuromuscular Nondepolarizing Agents / Q000037:antagonists & inhibitors; D011183:Postoperative Complications / Q000209:etiology*; D012120:Respiration Disorders / Q000209:etiology* / Q000503:physiopathology; D000077123:Rocuronium; D000077122:Sugammadex; D047408:gamma-Cyclodextrins / Q000008:administration & dosage / Q000009:adverse effects* / Q000494:pharmacology
chemical_list: D000732:Androstanols; D000777:Anesthetics; D003473:Neuromuscular Nondepolarizing Agents; D047408:gamma-Cyclodextrins; D000077122:Sugammadex; D000077123:Rocuronium