The Safe Use of Sugammadex “Rescue” after Neostigmine: 2 Case Reports

With the introduction of the rocuronium and vecuronium binding agent sugammadex into clinical practice in the United States, its use for reversal of neuromuscular blockade will likely start in some institutions as a “rescue” after failed reversal with neostigmine. However, sugammadex after neostigmine has not been extensively studied. Therefore, there is a question as to its effectiveness when used in this way especially in the airway compromised patients that the anesthesia provider will commonly face in this situation. Furthermore, there is a possibility of hemodynamic compromise. These two case reports demonstrate the safe and effective use of sugammadex after failed reversal with neostigmine.