Re-establishment of neuromuscular block by rocuronium after sugammadex administration
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To the Editor,
Patients occasionally may require reoperation in the immediate postoperative period. We present a case where rocuronium-induced neuromuscular block (NMB) was achieved more than 2 h after sugammadex had been given. Written consent for publication of the manuscript was granted by the patient.
A 65-year-old man (American Society of Anesthesiologists physical status III, weight 95 kg, body mass index 29.3 kg m−2) with a history of hypertension, dyslipidemia, and symptoms suggesting carotid vascular disease was scheduled for left carotid endarterectomy. Laboratory values were within normal limits. Two hours after the procedure while the patient was in the postanesthesia care unit, he developed an expanding neck hematoma without airway compromise and was brought back to the operating room for hematoma evacuation.
Following preoxygenation, anesthesia was induced slowly with fentanyl 100 μg, etomidate 15 mg, and rocuronium 50 mg (0.53 mg kg−1). Once the patient was unconscious,...
KeywordsRemifentanil Rocuronium Etomidate Neuromuscular Block Adductor Pollicis
The authors sincerely thank Professor Aaron F. Kopman, Weill Cornell Medical College, for his helpful assistance with manuscript revision and Dr. Lucas Mengibar Fuentes, vascular surgeon, for his collaboration in patient care.
Conflicts of interest
Gloria Veiga-Ruiz, Nuria Dominguez-Serrano, and Joaquin Fabregat-López have received speakers’ fees from MSD. No external funding and no competing interest declared.