Reversal of Profound Neuromuscular Blockade with Sugammadex after Failure of Rapid Sequence Endotracheal Intubation: a Case Report

SummaryBarbosa FT, Cunha RM – Reversal of Profound Neuromuscular Blockade with Sugammadex after Failure of Rapid Sequence Endotracheal Intubation: a Case Report.Background and objectivesSugammadex is a reversal agent that acts as a selective antagonist of neuromuscular blockade induced by rocuronium and vecuronium. This is a case report of an elderly female patient who had sugammadex just after rocuronium induction.Case reportAn 88-year-old female patient, 34kg, presented a femoral fracture and had to undergo general anesthesia after spinal anesthesia failure. Induction was performed with propofol 1.5mg.kg-1, rocuronium 1.2mg.kg-1, fentanyl 100mcg, and lidocaine 2mg.kg-1. There was no success in either tracheal intubation or laryngeal mask positioning maneuvers. The use of sugammadex at a dose of 16mg.kg-1 was required and respiratory function returned to normal.ConclusionLiterature recommends sugammadex at a dose of 16mg.kg-1 for patients with profound blockade. It was used in our patient with rapid and effective reversal of neuromuscular blockade allowing the patient to undergo another procedure to ensure the airway patency without clinical impairment of her general condition