A suspected case of sugammadex-induced anaphylactic shock: A case report

Hwang, Min Ho; Won, Young Ju; Lee, Il Ok; Koo, Eun Hye; Jung, Woo Jun

doi:2015.10.4.288

Anesth Pain Med > Volume 10(4); 2015 > Article

Case Report

Neuromuscular Physiology and Pharmacology

Anesthesia and Pain Medicine 2015;10(4):288-290.
DOI: https://doi.org/10.17085/apm.2015.10.4.288 Published online October 31, 2015.

A suspected case of sugammadex-induced anaphylactic shock: A case report

Min Ho Hwang, Young Ju Won, Il Ok Lee, Eun Hye Koo, Woo Jun Jung

Department of Anesthesiology and Pain Medicine, Guro Hospital, Korea University College of Medicine, Seoul, Korea. moma2@naver.com

Received: 15 May 2015 • Revised: 29 July 2015 • Accepted: 30 July 2015

Abstract

We describe a case involving a 69-year-old woman who developed anaphylatic shock caused by a clinical dose of sugammadex (2 mg/kg, 100 mg intravenously) 5 minutes after its administration. She developed redness and welts all over her body, and complained of an oropharyngeal itching sensation with dyspnea and dizziness. Her vital signs were closely monitored. She also experienced a sudden onset of hypotension (from 110/70 to 49/40 mmHg) and tachycardia (from 75 to 120 bpm). We diagnosed anaphylactic shock on the basis of these clinical manifestations. After 20 min of traditional treatment (hydration, ephedrine, cortisol, and phenylephrine), her vital signs returned to normal. No postoperative complications were evident, and the patient was discharged from the hospital. Although the prevalence of anaphylactic reactions to sugammadex is rare, physicians using sugammadex should be aware of the possibility of sugammadex-induced anaphylaxis.

Key Words: Anaphylactic shock, Hypersensitivity, Sugammadex