rocuronium and Gastroesophageal-Reflux

Sugammadex is a modified gamma cyclodextrin that encapsulates rocuronium. We report the successful use of sugammadex in the management of an elderly man with end-stage renal failure who sustained an infiltration of subcutaneous rocuronium during rapid sequence induction of general anesthesia. Given the erratic absorption of subcutaneous rocuronium from the tissue, sugammadex was chosen to reverse the neuromuscular block at the end of the procedure. This report demonstrates the efficacy of sugammadex to reverse neuromuscular block in elderly patients with poor renal function. Moreover, the duration of action for sugammadex was sufficient to neutralize the ongoing absorption of subcutaneous rocuronium.

Topics: Aged; Biopsy; Endoscopy, Gastrointestinal; Gastroesophageal Reflux; Humans; Kidney Failure, Chronic; Male; Renal Dialysis; Rocuronium; Sugammadex; Treatment Outcome

Sugammadex can reverse rocuronium-induced muscular relaxation by encapsulation of steroidal muscle relaxants without muscarinergic side effects. Clinical studies show effective dose-dependent reversal of neuromuscular blockades after rocuronium and vecuronium. We report on a patient with deep neuromuscular block at the end of surgery following rapid sequence induction of anesthesia with high-dose rocuronium, who could rapidly be reversed without side effects after adequate i.v. sugammadex application.

Topics: Androstanols; Anesthesia; Cholecystectomy, Laparoscopic; Contraindications; gamma-Cyclodextrins; Gastroesophageal Reflux; Humans; Hypertension; Intubation, Intratracheal; Male; Middle Aged; Neuromuscular Depolarizing Agents; Neuromuscular Nondepolarizing Agents; Preanesthetic Medication; Rocuronium; Sleep Apnea, Obstructive; Succinylcholine; Sugammadex