Failed reversal of neuromuscular blockade despite sugammadex: A case of undiagnosed pseudocholinesterase deficiency

نویسندگان

  • Gozde Inan
  • Elif Yayla
  • Berrin Gunaydin
چکیده

The management of an undetected pseudocholinesterase deficiency in a parturient who underwent urgent cesarean section has been presented. After rapid sequence induction with succinylcholine, rocuronium was used for maintenance of neuromuscular block. At the end of the operation neostigmine was given to antagonize the residual block. Upon persistent prolonged neuromuscular blockade sugammadex was administered. Probable reasons, drug interactions, the importance of suspecting pseudocholinesterase deficiency and the need of neuromuscular monitoring have been argued in this case report.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

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 ...

متن کامل

The Use of Sugammadex in an Infant with Larsen Syndrome

We describe the case ofa 2.5 kg weighing infant with Larsen syndrome that we used sugammadex for reversal of deep neuromuscular blockade. Sugammadex was superior to classical reversal agent neostigmine because of the effect on deep neuromuscular blockade and less side effects. Our patient had cervical instability, small for age and also entubation difficulty with facial anomaly. We discussed th...

متن کامل

Comparison between succinylcholine and rocuronium as neuromuscular blocking agents for electroconvulsive therapy in a patient with pseudocholinesterase deficiency

We report here the anesthetic management of a patient with schizophrenia and pseudocholinesterase deficiency. Electroconvulsive therapy was performed using succinylcholine and rocuronium as the neuromuscular blocking agents in the first seven and latter six treatments, respectively. The recovery time from muscle relaxation after succinylcholine administration was remarkably longer than that aft...

متن کامل

Use of sugammadex after neostigmine incomplete reversal of rocuronium-induced neuromuscular blockade.

BACKGROUND AND OBJECTIVES Neuromuscular blockers (NMB) have been used for more than half of a century in anesthesia and have always been a challenge for anesthesiologists. Until recently, the reversal of nondepolarizing neuromuscular blockers had only one option: the use of anticholinesterase agents. However, in some situations, such as deep neuromuscular blockade after high doses of relaxant, ...

متن کامل

Use of sugammadex in clinical practice

neostigmine), reverses neuromuscular blockade rapidly and effectively by encapsulating free circulating steroidal neuromuscular blocking agents (e.g., rocuronium) directly [1]. Moreover, sugammadex does not have muscarinic properties, whereas neostigmine has significant adverse muscarinic effects. Therefore, sugammadex is used in many countries as a new neuromuscular reversal agent to antagoniz...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره   شماره 

صفحات  -

تاریخ انتشار 2015