Reactions 1442 - 9 Mar 2013 S Sugammadex Suspected anaphylaxis in a child: case report A 7-year-old boy developed suspected anaphylaxis following sugammadex administration. The boy, who was intellectually compromised, had a history of cerebral palsy and orthopaedic surgery. He was scheduled for treatment of multiple dental cavities under general anaesthesia. On the day of treatment, he was intubated and given rocuronium bromide, atropine, propofol, remifentanil and lidocaine. He was extubated after the administration of sugammadex 40mg [route and indication not stated]. Approximately 3 minutes later, he exhibited signs of upper airway distress. He had external paradoxical respiration and high-pitched respiratory sounds. The boy received oxygen via a face mask, and his oxygen saturation normalised. However, a wheal appeared on his neck approximately 10 minutes after extubation. The wheal spread from his neck to his chest and upper extremities. He was suspected of having an anaphylactic response to sugammadex. He received epinephrine [adrenaline] and hydrocortisone. His BP increased to 160/120 mm Hg after treatment and fell to 126/84 mm Hg within minutes. His wheals and signs of upper airway stenosis resolved, and no severe complications developed. Author comment: "We suspected that the anaphylaxis in our patient was caused by the administration of sugammadex". Asahi Y, et al. Hypersensitivity reaction probably induced by sugammadex. Acta Anaesthesiologica Taiwanica 50: 183-184, No. 4, Dec 2012. Available from: URL: http://dx.doi.org/10.1016/j.aat.2012.08.010 - Japan 803084068 1 Reactions 9 Mar 2013 No. 1442 0114-9954/10/1442-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved

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Reactions 1442 - 9 Mar 2013

SSugammadex

Suspected anaphylaxis in a child: case reportA 7-year-old boy developed suspected anaphylaxis

following sugammadex administration.The boy, who was intellectually compromised, had a history

of cerebral palsy and orthopaedic surgery. He was scheduledfor treatment of multiple dental cavities under generalanaesthesia. On the day of treatment, he was intubated andgiven rocuronium bromide, atropine, propofol, remifentaniland lidocaine. He was extubated after the administration ofsugammadex 40mg [route and indication not stated].Approximately 3 minutes later, he exhibited signs of upperairway distress. He had external paradoxical respiration andhigh-pitched respiratory sounds.

The boy received oxygen via a face mask, and his oxygensaturation normalised. However, a wheal appeared on hisneck approximately 10 minutes after extubation. The whealspread from his neck to his chest and upper extremities. Hewas suspected of having an anaphylactic response tosugammadex. He received epinephrine [adrenaline] andhydrocortisone. His BP increased to 160/120 mm Hg aftertreatment and fell to 126/84 mm Hg within minutes. Hiswheals and signs of upper airway stenosis resolved, and nosevere complications developed.

Author comment: "We suspected that the anaphylaxis inour patient was caused by the administration ofsugammadex".Asahi Y, et al. Hypersensitivity reaction probably induced by sugammadex. ActaAnaesthesiologica Taiwanica 50: 183-184, No. 4, Dec 2012. Available from: URL:http://dx.doi.org/10.1016/j.aat.2012.08.010 - Japan 803084068