Sugammadex

Abstract

Anaphylactic shock: case report A 57-year-old patient [sex not stated] developed anaphylactic shock following treatment with sugammadex for reversal of neuromuscular blockade. Th patient, who underwent placement of gastric band with abdominoplasty in 2005 due to obesity, presented for gastric band removal surgery. The patient’s medical history was significant for post-smoking chronic bronchitis and topical allergic allergies, including a contact allergy to sparadrap. The patient was hospitalised. The patient was administered rocuronium bromide [rocuronium] for neuromuscular blockade, along with various other concomitant medications. At the end of the surgical intervention, reversal of neuromuscular blockade was scheduled. The patient was administered an injection of sugammadex [BRIDION] 2 mg/kg of theoretical ideal weight. Subsequently, the patient developed generalised hives with haemodynamic failure characterised by low BP and tachycardia. Grade II anaphylactic shock secondary to sugammadex was considered [time to reaction onset not clearly stated]. The patient was treated with ephedrine, hydrocortisone, salbutamol and unspecified ringer. Thereafter, the patient’s skin manifestations disappeared and haemodynamic stabilisation was achieved. The patient was extubated and was transferred to the ICU. Subsequent skin tests for ropivacaine, suxamethonium chloride, atracurium besilate, mivacurium chloride, rocuronium bromide, cisatracurium besilate as well as sufentanil, propofol and latex demonstrated negative results. Sugammadex test was noted to be positive at 11mm at 1:10.