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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.
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http://dx.doi.org/10.1213/XAA.0000000000000934 | DOI Listing |
Eur J Anaesthesiol
January 2025
From the Department of Internal and Emergency Medicine, Kantonsspital Aarau, Aarau (YAW) and Department of Anaesthesia and Critical Care Medicine, Buergerspital Solothurn, Solothurn, Switzerland (FM).
Eur J Anaesthesiol
May 2024
From the Department of Anaesthesiology, UZ Leuven, Leuven, Belgium (FN, VG), Department of Anaesthesiology, Ziekenhuis Oost-Limburg, Genk, Belgium (IVH) and Department of Anaesthesiology, AZ Turnhout, Turnhout, Belgium (FS).
Extravascular injection of neuromuscular blocking drugs (NMBDs) can cause a neuromuscular block because of systemic absorption. Currently, there are no guidelines available on managing extravasation of NMBDs. This article reviews the available literature on extravasation of NMBDs.
View Article and Find Full Text PDFAnesth Prog
September 2023
Department of Dental Anesthesiology, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan.
There are few reports on rocuronium infiltration under general anesthesia. We report a case of suspected accidental rocuronium infiltration during anesthesia induction. A 25-year-old woman with autism spectrum disorder, intellectual disability, and epilepsy was scheduled for the extraction of 4 impacted third molars under general anesthesia.
View Article and Find Full Text PDFJ Clin Monit Comput
April 2022
Department of Anesthesiology, Nihon University School of Medicine, 30-1, Oyaguchi Kamimachi, Itabashi-Ku, Tokyo, 173-8610, Japan.
The duration of action of extravasated rocuronium varies depending on the patient's comorbidities. In patients who receive high doses of non-depolarizing neuromuscular blocking agents subcutaneously, anesthesiologists should be aware of unexpected prolongation of the progress and recovery of neuromuscular block. In such cases, the depth and recovery of neuromuscular block should be objectively monitored to avoid residual neuromuscular block and recurarization.
View Article and Find Full Text PDFJA Clin Rep
February 2021
Department of Anesthesiology, Nihon University, School of Medicine, 30-1, Oyaguchi, Kami-cho, Itabashi-ku, Tokyo, 173-8610, Japan.
Background: Drugs administered subcutaneously have delayed onset and prolonged duration of action versus those given intravenously. Since the duration of action of rocuronium is prolonged in patients with renal dysfunction, subcutaneous administration of rocuronium to such patients might significantly prolong its effect.
Case Presentation: A 51-year-old female with chronic renal failure was accidentally administered 1.