Article
Multidisciplinary Sciences
Razvan Bologheanu, Paul Lichtenegger, Mathias Maleczek, Daniel Laxar, Eva Schaden, Oliver Kimberger
Summary: This study retrospectively evaluated the use of Sugammadex in critically ill patients and found that it was well tolerated and could be considered for the reversal of neuromuscular blockade. However, larger prospective studies are needed to determine its safety profile and potential benefits in the critical care setting.
SCIENTIFIC REPORTS
(2022)
Article
Medicine, Research & Experimental
Sheng-Kai Hung, Chia-Chi Yeh, Pei-Chi Ting, Cay-Huyen Chen, Ming-Chang Kao
Summary: Although rare, anaphylaxis during anesthesia can be caused by neuromuscular blocking drugs. This case report highlights the potential benefit of using sugammadex as an adjunct treatment option for rocuronium-induced anaphylaxis.
JOURNAL OF INTERNATIONAL MEDICAL RESEARCH
(2022)
Article
Allergy
Asger Sverrild, John Carruthers, Kavitha Garuna Murthee, Alice Moore, Robyn Elizabeth O'Hehir, Robert Puy, Mark Hew, Celia Zubrinich
Summary: This study evaluated a published algorithm based on tryptase and clinical presentation to identify appropriate individuals for further testing for IgE-mediated perioperative hypersensitivity (POH). The results showed that the algorithm was highly sensitive but less specific in identifying patients testing positive on skin testing and/or specific IgE. Cardiovascular symptoms had high sensitivity, while the combination of respiratory symptoms and increased tryptase had the highest specificity. Respiratory involvement was more common in neuromuscular blocking agent allergy, while urticaria/angioedema was more common in antibiotic allergy.
Article
Allergy
Deepti Vellaichamy Manian, Gerald W. Volcheck
Summary: Perioperative anaphylaxis is a rare and life-threatening condition that requires immediate stabilization of the patient and identification of the culprit agent to prevent unnecessary drug allergy labeling and provide guidance for future surgeries. Close collaboration between different medical teams is essential for appropriate management of these patients.
CLINICAL REVIEWS IN ALLERGY & IMMUNOLOGY
(2022)
Article
Anesthesiology
T. Andrew Bowdle, Kishanee J. Haththotuwegama, Srdjan Jelacic, Sharon T. Nguyen, Kei Togashi, Kelly E. Michaelsen
Summary: Sugammadex dose titration is necessary for effective reversal of neuromuscular blockade after rocuronium administration. Most patients require less than the recommended dose, but some may need more, and recurrent paralysis can occur.
Article
Anesthesiology
Paulo A. Germano-Filho, Ismar L. Cavalcanti, Angelo J. Q. R. Micuci, Luis G. C. Velarde, Hans D. de Boer, Nubia Vercosa
Summary: The objective of this study was to test the hypothesis that magnesium sulfate after reversal with sugammadex causes recurarization. The study was designed as a single-center, prospective, randomized, double-blind, controlled trial. The results showed that in the magnesium sulfate group, 64% of patients with deep blockade and 73% of patients with moderate blockade experienced recurarization, while in the placebo group, only 7% and 0% of patients experienced recurarization, respectively. This study demonstrated that a single dose of magnesium sulfate led to recurarization in patients who had recovered from rocuronium-induced deep and moderate neuromuscular blockade using sugammadex, and additional sugammadex could reverse prolonged recurarization.
JOURNAL OF CLINICAL ANESTHESIA
(2023)
Article
Allergy
Aleena Banerji, Gita Bhattacharya, Emily Huebner, Xiaoqing Fu, Carlos A. Camargo, Autumn Guyer, James L. Kuhlen, Kimberly G. Blumenthal
Summary: The majority of patients evaluated at Massachusetts General Hospital by Allergy/Immunology safely received subsequent anesthesia after comprehensive evaluation. Among the patients, antibiotics (especially cefazolin) were the most common culprits among those who tested positive, accounting for 24%. An elevated baseline tryptase level was associated with an increased risk of recurrent perioperative allergic reactions.
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE
(2021)
Article
Medicine, Research & Experimental
Cristian Aragon-Benedi, Sara Visiedo-Sanchez, Ana Pascual-Bellosta, Sonia Ortega-Lucea, Rafael Fernandez-Liesa, Javier Martinez-Ubieto
Summary: The study found that using rocuronium in microlaryngeal surgery can provide better surgical conditions, lower doses of remifentanil, shorten awakening time, and reduce complications associated with high doses of remifentanil.
Review
Allergy
Gerald W. Volcheck, Birgitte Bech Melchiors, Sophie Farooque, Alexei Gonzalez-Estrada, Paul Michel Mertes, Louise Savic, Charles Tacquard, Lene Heise Garvey
Summary: Perioperative hypersensitivity (POH) is a rare but potentially life-threatening event, and its identification can be challenging due to various factors. This paper presents a practical approach to managing POH, including understanding the operating room environment, distinguishing between immunological and nonimmunological reactions, acute management, and follow-up evaluation. Collaboration between the anesthesia and allergy teams is crucial throughout the process.
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE
(2023)
Article
Medicine, General & Internal
Juan Fiorda Diaz, Marco Echeverria-Villalobos, Alan Esparza Gutierrez, Olufunke Dada, Nicoleta Stoicea, Wiebke Ackermann, Mahmoud Abdel-Rasoul, Jarrett Heard, Alberto Uribe, Sergio D. D. Bergese
Summary: This study compared the effectiveness and cost-effectiveness of sugammadex and neostigmine for moderate neuromuscular blockade reversal. The results showed that sugammadex achieved faster reversal without increasing perioperative costs.
FRONTIERS IN MEDICINE
(2022)
Article
Anesthesiology
Kohji Uzawa, Hiroyuki Seki, Tomoko Yorozu
Summary: In this case, the recommended dose of sugammadex failed to completely reverse the rocuronium-induced neuromuscular blockade, requiring an additional dose of sugammadex to return to normal levels.
BMC ANESTHESIOLOGY
(2021)
Article
Anesthesiology
Sakiko Hiramatsu, Katsuyuki Moriwaki, Miwako Nakao, Yasuo M. Tsutsumi
Summary: This case illustrates that rocuronium can lead to prolonged neuromuscular respiratory paralysis that is resistant to sugammadex in patients with CMT1A and impaired respiratory function. Furthermore, restrictive pulmonary impairment and a low nerve conduction velocity of 20 m/s may be predictive factors for prolonged neuromuscular respiratory paralysis that is resistant to sugammadex in CMT1A patients.
CANADIAN JOURNAL OF ANESTHESIA-JOURNAL CANADIEN D ANESTHESIE
(2022)
Article
Anesthesiology
Panpan Zhang, Xiaowen Liu, Weixia Li, Ruisong Gong, Jun Zuo, Ruihua Sun, Jing Zhao, Mercedes S. Mandell
Summary: The incidence of perioperative anaphylaxis in China is 1 in 11,360, varying significantly by region. Common clinical manifestations include hypotension and tachycardia. Some patients require cardiopulmonary resuscitation, and a few ultimately die.
BRITISH JOURNAL OF ANAESTHESIA
(2022)
Article
Anesthesiology
Sayomi Tsukada, Sayuri Shimizu, Kiyohide Fushimi
Summary: The study found that using rocuronium reversed by sugammadex in the anaesthetic management of patients with myasthenia gravis undergoing thymectomy did not increase the risk of respiratory complications, and significantly shortened the length of hospital stay.
EUROPEAN JOURNAL OF ANAESTHESIOLOGY
(2021)
Review
Emergency Medicine
Skyler Lentz, Katelin M. Morrissette, Blake A. Porter, Kyle M. DeWitt, Alex Koyfman, Brit Long
Summary: Sugammadex is a newly available medication that rapidly reverses neuromuscular blockade. It can facilitate urgent neurological examinations, but its routine use in failed or difficult airway management is not supported by literature. It is important to prioritize oxygenation and ventilation in such situations.
JOURNAL OF EMERGENCY MEDICINE
(2021)