Sugammadex induced bradycardia and hypotension: A case report and literature review.

I-Chia Teng, Ying-Jen Chang, Yao-Tsung Lin, Chin-Chen Chu, Jen-Yin Chen, Zhi-Fu Wu

Medicine 2021 Jul 30

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There is evidence that sugammadex can facilitate extubation post-surgery and attenuate postoperative pulmonary complications resulting from postoperative residual neuromuscular blockade. However, it may induce adverse effects, including bronchospasm, laryngospasm, bradycardia, hypotension, and cardiac arrest. Here, we present a case of sugammadex-induced bradycardia and hypotension. An 82-year-old female received video-assisted thoracic surgery decortication and wedge resection of the lung for empyema. Post-surgery, she developed bradycardia, hypotension, hypoxia, and weakness. The patient was suspected to have sugammadex-induced bradycardia, hypotension, hypoxia and weakness. The patient received immediate treatment with atropine (0.5 mg) for bradycardia. Glycopyrrolate (0.1 mg) and neostigmine (1 mg) were administered to improve the train-of-four (TOF) ratio. Following initial management, we observed improvement in the hemodynamics of the patient. She was discharged without any sequelae. Sugammadex-induced bradycardia or cardiac arrest are rare; however, anesthesiologists must consider the possibility of the occurrence of such events and initiate appropriate management measures. Immediate treatment with atropine and inotropic or vasopressors is warranted if the patient presents with bradycardia. Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

Citation

I-Chia Teng, Ying-Jen Chang, Yao-Tsung Lin, Chin-Chen Chu, Jen-Yin Chen, Zhi-Fu Wu. Sugammadex induced bradycardia and hypotension: A case report and literature review. Medicine. 2021 Jul 30;100(30):e26796