Korean J Anesthesiol.  2019 Oct;72(5):495-499. 10.4097/kja.d.18.00232.

Anaphylactic shock after sugammadex administration, induced by formation of a sugammadex-rocuronium complex: a case report

• Kim GH
• Choi WS
• Kim JE
• Yun MJ
• Koo MS
• Kwon M
• Seo H

• KMID: 2465749
• DOI: http://doi.org/10.4097/kja.d.18.00232

Abstract

BACKGROUND
Sugammadex is a reversal agent for non-depolarizing neuromuscular blockers and widely used worldwide on account of its rapid and effective reversal from neuromuscular blockade, despite its advantages, multiple cases of sugammadex-induced anaphylactic shock have been reported. CASE: A 42-year-old man developed anaphylactic shock in the postanesthesia care unit. Initially, sugammadex was suspected as the causative agent, but an intradermal skin test revealed negative results. A further skin test was performed with sugammadex-rocuronium complex that yielded positive results.
CONCLUSIONS
Anesthesiologists and healthcare providers should be aware of the possibility of anaphylaxis from the sugammadex-rocuronium complex, as well as from sugammadex or rocuronium alone.

Keyword

Anaphylactic shock; Cyclodextrin; Epinephrine; Hypersensitivity; Rocuronium; Sugammadex

MeSH Terms

Adult
Anaphylaxis*
Epinephrine
Health Personnel
Humans
Hypersensitivity
Neuromuscular Blockade
Neuromuscular Blocking Agents
Skin Tests
Epinephrine
Neuromuscular Blocking Agents