Suspected Sugammadex Hypersensitivity following Repeated Administration in the Setting of Multiple Flap Takebacks in a Brief Timespan
Sugammadex hypersensitivity is an uncommon event that typically occurs at higher doses. We report a case of suspected sugammadex hypersensitivity in a patient who developed hypoxia and bronchospasm following three administrations of the standard 2 mg/kg doses of sugammadex within 26 hours due to fla...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Case Reports in Anesthesiology |
| Online Access: | http://dx.doi.org/10.1155/2021/5716159 |
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| author | Elizabeth G. Zolper Alan H. Kim Kevin G. Kim Paige K. Dekker Jenna C. Bekeny David H. Song Kenneth L. Fan |
| author_facet | Elizabeth G. Zolper Alan H. Kim Kevin G. Kim Paige K. Dekker Jenna C. Bekeny David H. Song Kenneth L. Fan |
| author_sort | Elizabeth G. Zolper |
| collection | DOAJ |
| description | Sugammadex hypersensitivity is an uncommon event that typically occurs at higher doses. We report a case of suspected sugammadex hypersensitivity in a patient who developed hypoxia and bronchospasm following three administrations of the standard 2 mg/kg doses of sugammadex within 26 hours due to flap takebacks. Hypersensitivity to sugammadex was not initially suspected given that the patient had previous exposures. Diagnoses of pneumothorax, hemothorax, mucus plug, and tracheal tube malposition were immediately ruled out. Furthermore, the onset of hypoxia with sudden loss of tidal volume, development of high peak airway pressures, and temporal correlation with sugammadex administration all supported bronchospasm secondary to a hypersensitivity reaction. Sugammadex is a useful agent for neuromuscular blockade reversal; however, it is critical to carefully examine all adverse reactions. This case report highlights the importance of considering hypersensitivity reactions in the setting of repeat sugammadex administrations in a limited timeframe, such as in free flap reconstruction requiring multiple takebacks to the operating room in the setting of flap compromise. |
| format | Article |
| id | doaj-art-c71a9b6a5d204421815ff78e2af12abc |
| institution | Kabale University |
| issn | 2090-6382 2090-6390 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Anesthesiology |
| spelling | doaj-art-c71a9b6a5d204421815ff78e2af12abc2025-02-03T05:43:47ZengWileyCase Reports in Anesthesiology2090-63822090-63902021-01-01202110.1155/2021/57161595716159Suspected Sugammadex Hypersensitivity following Repeated Administration in the Setting of Multiple Flap Takebacks in a Brief TimespanElizabeth G. Zolper0Alan H. Kim1Kevin G. Kim2Paige K. Dekker3Jenna C. Bekeny4David H. Song5Kenneth L. Fan6Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, 3800 Reservoir Road Northwest, Washington, DC 20007, USADepartment of Anesthesiology, MedStar Georgetown University Hospital, 3800 Reservoir Road Northwest, Washington, DC 20007, USADepartment of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, 3800 Reservoir Road Northwest, Washington, DC 20007, USADepartment of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, 3800 Reservoir Road Northwest, Washington, DC 20007, USADepartment of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, 3800 Reservoir Road Northwest, Washington, DC 20007, USADepartment of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, 3800 Reservoir Road Northwest, Washington, DC 20007, USADepartment of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, 3800 Reservoir Road Northwest, Washington, DC 20007, USASugammadex hypersensitivity is an uncommon event that typically occurs at higher doses. We report a case of suspected sugammadex hypersensitivity in a patient who developed hypoxia and bronchospasm following three administrations of the standard 2 mg/kg doses of sugammadex within 26 hours due to flap takebacks. Hypersensitivity to sugammadex was not initially suspected given that the patient had previous exposures. Diagnoses of pneumothorax, hemothorax, mucus plug, and tracheal tube malposition were immediately ruled out. Furthermore, the onset of hypoxia with sudden loss of tidal volume, development of high peak airway pressures, and temporal correlation with sugammadex administration all supported bronchospasm secondary to a hypersensitivity reaction. Sugammadex is a useful agent for neuromuscular blockade reversal; however, it is critical to carefully examine all adverse reactions. This case report highlights the importance of considering hypersensitivity reactions in the setting of repeat sugammadex administrations in a limited timeframe, such as in free flap reconstruction requiring multiple takebacks to the operating room in the setting of flap compromise.http://dx.doi.org/10.1155/2021/5716159 |
| spellingShingle | Elizabeth G. Zolper Alan H. Kim Kevin G. Kim Paige K. Dekker Jenna C. Bekeny David H. Song Kenneth L. Fan Suspected Sugammadex Hypersensitivity following Repeated Administration in the Setting of Multiple Flap Takebacks in a Brief Timespan Case Reports in Anesthesiology |
| title | Suspected Sugammadex Hypersensitivity following Repeated Administration in the Setting of Multiple Flap Takebacks in a Brief Timespan |
| title_full | Suspected Sugammadex Hypersensitivity following Repeated Administration in the Setting of Multiple Flap Takebacks in a Brief Timespan |
| title_fullStr | Suspected Sugammadex Hypersensitivity following Repeated Administration in the Setting of Multiple Flap Takebacks in a Brief Timespan |
| title_full_unstemmed | Suspected Sugammadex Hypersensitivity following Repeated Administration in the Setting of Multiple Flap Takebacks in a Brief Timespan |
| title_short | Suspected Sugammadex Hypersensitivity following Repeated Administration in the Setting of Multiple Flap Takebacks in a Brief Timespan |
| title_sort | suspected sugammadex hypersensitivity following repeated administration in the setting of multiple flap takebacks in a brief timespan |
| url | http://dx.doi.org/10.1155/2021/5716159 |
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