A Case of Respiratory Arrest Caused by Recurarization and Treated with Sugammadex through Antagonism of Neuromuscular Block

• Published in: THE JOURNAL OF JAPAN SOCIETY FOR CLINICAL ANESTHESIA Vol. 41; no. 5; pp. 475 - 479
• Main Authors: UCHIDA, Kentaro, KITAMURA, Akira, TSUJITA, Miki, NAKAGAWA, Hideyuki, NAKAYAMA, Hideto
• Format: Journal Article
• Language: Japanese
• Published: THE JAPAN SOCIETY FOR CLINICAL ANESTHESIA 15.09.2021
• Subjects: Muscle relaxant; Recurarization; Renal dysfunction; Respiratory arrest; Target controlled infusion
• ISSN: 0285-4945; 1349-9149
• DOI: 10.2199/jjsca.41.475

We report a case of postoperative respiratory arrest with the suspicion of recurarization in a 69-year-old man with left pyelolithiasis who was scheduled for left percutaneous nephrolithotrispy under general anesthesia. He had a history of diabetes and renal dysfunction and had undergone a total pelvic surgery for sigmoid colon cancer and partial hepatectomy for metastatic liver cancer. During anesthesia, rocuronium was used as a muscle relaxant with a pharmacokinetic model as a reference, without any neuromuscular monitoring. Post-surgery, sugammadex was administered to the patient. Further, he was extubated after the recovery of spontaneous respiration and showed no abnormal vital signs, so he was allowed to leave the operating room. Seventy-five minutes after returning to the ward, he suffered from respiratory arrest. Re-administration of sugammadex helped in recovering spontaneous respiration.We conclude that neuromuscular monitoring in patients is necessary and sugammadex should be administered adequately for the prevention of recurarization.