rocuronium and Hyperkalemia

Topics: Androstanols; Humans; Hyperkalemia; Neuromuscular Depolarizing Agents; Rocuronium; Succinylcholine

Topics: Androstanols; Humans; Hyperkalemia; Neuromuscular Depolarizing Agents; Rocuronium; Succinylcholine

We report a case of delayed rocuronium-induced deep block antagonization with sugammadex, thus requiring a total of three injections and a cumulative dose of 12 mg/kg over a 30 min period. The patient was an emergency case with full stomach that had required a rapid sequence induction. Because of hyperkaliemia due to an acute renal failure, rocuronium was preferred to succinylcholine. Use of sugammadex in the acute renal failure context is discussed.

Topics: Acute Kidney Injury; Aged; Androstanols; Anesthesia, General; Emergency Medical Services; Female; gamma-Cyclodextrins; Hemodynamics; Humans; Hydronephrosis; Hyperkalemia; Kidney Neoplasms; Neuromuscular Nondepolarizing Agents; Rocuronium; Sugammadex; Uterine Cervical Neoplasms

Gordon's syndrome is a rare condition characterized by hypertension and hyperkalemia despite normal renal glomerular function. We report the administration of an anaesthetic to one such patient for an urgent surgical procedure. The patient's serum potassium was only marginally raised at the outset of the procedure. During surgery the serum potassium rose significantly, but responded to conventional management. Hyperkalaemia is a specific electrolyte disturbance that has numerous implications for the administration of an anaesthetic. Most importantly, there is a danger that further acute elevations may occur, caused by the surgery, the anaesthetic, or the condition itself

Topics: Accidents, Traffic; Androstanols; Anesthesia; Emergencies; Glomerular Filtration Rate; Humans; Hyperkalemia; Hypertension; Male; Middle Aged; Neuromuscular Nondepolarizing Agents; Potassium; Rocuronium; Syndrome