Korean J Anesthesiol.  2014 Jul;67(1):43-47. 10.4097/kjae.2014.67.1.43.

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

• Lee HJ
• Kim KS
• Kim TY
• Lee JH
• Jeong M

• KMID: 2236205
• DOI: http://doi.org/10.4097/kjae.2014.67.1.43

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.

Keyword

Postoperative hemorrhage; Rocuronium; Sugammadex; Tonsillectomy

MeSH Terms

Anesthesia, General
Hemorrhage*
Humans
Neuromuscular Blockade*
Neuromuscular Blocking Agents
Postoperative Hemorrhage
Sleep Apnea, Obstructive
Tonsillectomy
Young Adult
Neuromuscular Blocking Agents