Sugammadex hypersensitivity-a case of anaphylaxis.
We describe a case of a patient undergoing open abdominal aneurysm surgery who developed a severe, life-threatening allergic reaction immediately after administration of sugammadex. The manifestation was purely a cardiovascular collapse. The mainstay of treatment was administration of high-dose adrenaline and fluid resuscitation. The diagnosis of anaphylaxis was supported by a positive serum mast cell tryptase (93 µg/l) at one hour post-event. Sugammadex was confirmed as the cause of the anaphylaxis by a positive intradermal allergy test (25 mm diameter response to 1:100 dilution), with a normal saline control and a negative response to the other drugs used during the event. This case report is a reminder that the use of sugammadex is associated with rare but serious risks.
Department of Anaesthesia, The Queen Elizabeth Hospital, South Australia, Australia.
J
J
Jeyadoss
P
P
Kuruppu
N
N
Nanjappa
Rraw
R
Van Wijk
D000707:Anaphylaxis / Q000139:chemically induced* / Q000628:therapy; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery; D004342:Drug Hypersensitivity / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019148:Neuromuscular Blockade; D000077122:Sugammadex; D047408:gamma-Cyclodextrins / Q000009:adverse effects*
D047408:gamma-Cyclodextrins; D000077122:Sugammadex
anaphylaxis; sugammadex