The use of 3 sugammadex out of 5 reversal of during recovery of rocuronium-induced neuromuscular blockade in a patient with post-tonsillectomy hemorrhage: a case report.
10.4097/kjae.2014.67.1.43
- Author:
Hee Jong LEE
1
;
Kyo Sang KIM
;
Tae Yeon KIM
;
Jeoung Hyuk LEE
;
Miae JEONG
Author Information
1. Department of Anesthesiology and Pain Medicine, Hanyang University College of Medicine, Seoul, Korea. kimks@hanyang.ac.kr
- Publication Type:Case Report
- Keywords:
Postoperative hemorrhage;
Rocuronium;
Sugammadex;
Tonsillectomy
- MeSH:
Anesthesia, General;
Hemorrhage*;
Humans;
Neuromuscular Blockade*;
Neuromuscular Blocking Agents;
Postoperative Hemorrhage;
Sleep Apnea, Obstructive;
Tonsillectomy;
Young Adult
- From:Korean Journal of Anesthesiology
2014;67(1):43-47
- CountryRepublic of Korea
- Language:English
-
Abstract:
Post-tonsillectomy hemorrhage (PTH) is the most frequent complication of tonsillectomy, and occasionally results in a lethal outcome. A 21-year-old man (height 180 cm, weight 95 kg) was scheduled for a bilateral tonsillectomy and uvulopalatopharyngoplasty for treatment of obstructive sleep apnea. He required 5 rounds of general anesthesia due to recurrent PTH. The anesthesiologist used sugammadex a total of 3 times to achieve the successful reversal of the deep neuromuscular blockade (NMB) induced by rocuronium. After sugammadex 2 mg/kg was administered, the NMB was reversed in 2 minutes each time. Re-administration of rocuronium within a short time interval after sugammadex may result in unpredictable effects of neuromuscular blocking agents. Sugammadex made it possible to perform a rapid, complete reverse when the residual block was maintained by an incomplete reversal of anticholinesterase.