Sugammadex and recurarization in an infant.

Abstract

Sugammadex is a novel pharmacologic agent, which re- verses neuromuscular blockade via a mechanism that dif- fers completely from acetylcholinesterase inhibitors such as neostigmine. By encapsulating rocuronium or vecu- ronium, sugammadex provides rapid and complete recov- ery of neuromuscular function even when there is pro- found neuromuscular blockade. In general, clinical trials and experience with sugammadex have demonstrated its superiority over acetylcholinesterase inhibitors. Alt- hough generally effective, there may be the potential for recurrence of neuromuscular blockade despite effective reversal. We present a 4-month old infant who developed recurarization after the administration of sugammadex to reverse neuromuscular blockade. Previous reports of this adverse effect are reviewed, mechanisms discussed, and strategies to limits its incidence presented.

Keywords

• sugammadex
• residual paralysis
• neuromuscular block- ade