title: The use of 3 sugammadex out of 5 reversal of during recovery of rocuronium-induced neuromuscular blockade in a patient with post-tonsillectomy hemorrhage: a case report.
abstract: Post-tonsillectomy hemorrhage (PTH) is the most frequent complication of tonsillectomy, and occasionally results in a lethal outcome. A 21-year-old man (height 180 cm, weight 95 kg) was scheduled for a bilateral tonsillectomy and uvulopalatopharyngoplasty for treatment of obstructive sleep apnea. He required 5 rounds of general anesthesia due to recurrent PTH. The anesthesiologist used sugammadex a total of 3 times to achieve the successful reversal of the deep neuromuscular blockade (NMB) induced by rocuronium. After sugammadex 2 mg/kg was administered, the NMB was reversed in 2 minutes each time. Re-administration of rocuronium within a short time interval after sugammadex may result in unpredictable effects of neuromuscular blocking agents. Sugammadex made it possible to perform a rapid, complete reverse when the residual block was maintained by an incomplete reversal of anticholinesterase.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Hee-Jong
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Kyo Sang
authors.initials: KS
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Tae Yeon
authors.initials: TY
authors.lastname: Kim
authors.affiliation: Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Korea.
authors.forename: Jeoung Hyuk
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Miae
authors.initials: M
authors.lastname: Jeong
keywords: Postoperative hemorrhage; Rocuronium; Sugammadex; Tonsillectomy
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