Reversal of a rocuronium-induced grade IV anaphylaxis via early injection of a large dose of sugammadex
Can J
Anaesth. 2014 Jun;61(6):558-562
A 22-yr-old female without relevant medical history developed an
anaphylactic reaction within three minutes of rocuronium injection at induction
of anesthesia for a routine cholecystectomy. During the first
six minutes, she was unresponsive to usual treatment and her condition evolved
to a grade IV anaphylaxis reaction despite a cumulated dose of epinephrine
0.7 mg. Sugammadex 14 mg·kg-1, injected six minutes
after rocuronium, resulted in total resolution of all manifestations of
anaphylaxis within three minutes. The patient was discharged from hospital the
next day. Allergy investigations confirmed rocuronium as the cause of
anaphylaxis.
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