Sugammadex induced bradycardia and hypotension A case report and literature review

被引:13
作者
Teng, I-Chia [1 ]
Chang, Ying-Jen [1 ]
Lin, Yao-Tsung [1 ,2 ]
Chu, Chin-Chen [1 ]
Chen, Jen-Yin [1 ]
Wu, Zhi-Fu [3 ,4 ,5 ]
机构
[1] Chi Mei Med Ctr, Dept Anesthesiol, Tainan, Taiwan
[2] Chia Nan Univ Pharm & Sci, Dept Food Sci & Technol, Tainan, Taiwan
[3] Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Dept Anesthesiol, 100,Tzyou 1st Rd, Kaohsiung 807, Taiwan
[4] Tri Serv Gen Hosp, Taipei, Taiwan
[5] Natl Def Med Ctr, Dept Anesthesiol, Taipei, Taiwan
关键词
bradycardia; cardiac arrest; hypotension; sugammadex; NEUROMUSCULAR BLOCKADE; CARDIAC-ARREST; REVERSAL; MULTICENTER; ASYSTOLE;
D O I
10.1097/MD.0000000000026796
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Rationale: There is evidence that sugammadex can facilitate extubation post-surgery and attenuate postoperative pulmonary complications resulting from postoperative residual neuromuscular blockade. However, it may induce adverse effects, including bronchospasm, laryngospasm, bradycardia, hypotension, and cardiac arrest. Here, we present a case of sugammadex-induced bradycardia and hypotension. Patient concerns: An 82-year-old female received video-assisted thoracic surgery decortication and wedge resection of the lung for empyema. Post-surgery, she developed bradycardia, hypotension, hypoxia, and weakness. Diagnoses: The patient was suspected to have sugammadex-induced bradycardia, hypotension, hypoxia and weakness. Interventions: The patient received immediate treatment with atropine (0.5 mg) for bradycardia. Glycopyrrolate (0.1 mg) and neostigmine (1 mg) were administered to improve the train-of-four (TOF) ratio. Outcomes: Following initial management, we observed improvement in the hemodynamics of the patient. She was discharged without any sequelae. Lessons: Sugammadex-induced bradycardia or cardiac arrest are rare; however, anesthesiologists must consider the possibility of the occurrence of such events and initiate appropriate management measures. Immediate treatment with atropine and inotropic or vasopressors is warranted if the patient presents with bradycardia.
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页数:6
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