Sugammadex for active reversal of neuromuscular blockade induced by rocuronium for Caesarean section in general anaesthesia – series of case reports
Authors:
Štourač Petr 1; Kosinová Martina 1; Bártíková Ivana 1; Klučka Jozef 1; Křikava Ivo 1; Štoudek Roman 1; Harazim Hana 1; Huser Martin 2; Janků Petr 2; Gál Roman 1
Authors place of work:
Klinika anesteziologie, resuscitace a intenzivní medicíny FN Brno a LF MU, Brno
1; Gynekologicko-porodnická klinika FN Brno a LF MU, Brno
2
Published in the journal:
Anest. intenziv. Med., 24, 2013, č. 3, s. 163-167
Category:
Anaesthesiology - Case Report
Summary
Sugammadex is a selective relaxant-binding agent, which reverses rocuronium-induced neuromuscular blocks of any depth. We reported six Caesarean sec-tion cases undergoing general anaesthesia with propofol(1.6–2.3 mg/kg) or thiopental (4.1–5.6 mg/kg) and rocuronium (0.8–1.1 mg/kg) or sukcinylcholin(1.0–1.5 mg/kg) for the induction of neuromuscular blockade. Rocuronium was used for the maintenance of neromuscular blockade (0.4–0.5 mg/kg). At the end of the procedure, all the patients had a significant degree of neuromuscular block. In one patient, there was no single twitch response and no TOF-ratio, three patients had shallow neuromuscular blockade (TOF > 1) and two of them had no clinical signs of neuromuscular recovery (TOF monitoring not used). The same single dose of sugammadex 200 mg (1.7–3.2 mg/kg) was given. In all patients, sugammadex provided rapid and sufficient reversal to full muscle strenght. All patients were monitored after the operation and no signs of recurarization or neuromuscular weakness were observed.
Keywords:
sugammdex – Caesarean section – general anaesthesia – neuromusclar blockade – Rapid Sequence Induction
Zdroje
1. Štourač, P. Obstetric Anaesthesia and Analgesia Month Attributes – reálná zpráva o anesteziologické praxi na českých porodních odděleních. Anest. intenziv. Med., 24, 2013, 2, s. 81–82.
2. Saving Mothers’ Lives: Reviewing maternal deaths to make motherhood safer: 2006–08. The Eighth Report on the Confidential Enquiries into Maternal Deaths in the United Kingdom. BJOG, 2011;118 (Suppl 1), p. 1–203.
3. Sharp, L. M., Levy, D. M. Rapid sequence induction in obstetrics revisited. Curr. Opin. Anaesthesiol., 2009, Jun, 22, 3, p.: 357–361.
4. McIver, T., Jolley, D., Pescod, D. General anaesthesia and Caesarean section for a patient with hereditary spastic paraparesis (Strumpell’s disease). Int. J. Obstet. Anesth., 2007, 16, p.: 190–191.
5. Stourac, P., Krikava, I., Seidlova, J., Strazevska, E., Huser, M., Hruban, L., Janku, P., Gal, R. Sugammadex in a parturient with myotonic dystrophy. Br. J. Anaesth., 2013, Apr, 110, 4, p.: 657–658, doi: 10.1093/bja/aet037.
6. Garcia, V., Diemunsch, P., Boet, S. Use of rokuronium and sugammadex for caesarean delivery in a patient with myasthenia gravis. Int. J. Obstet. Anesth., 2012, Jul, 21, 3, p.: 286–287, doi: 10.1016/j.ijoa.2012.02.006.
7. Abu-Halaweh, S. A., Massad, I. M., Abu-Ali, H. M. et al. Rapid sequence induction and intubation with 1 mg/kg rokuronium bromide in cesarean section: Comparison with suxamethonium. Saudi Med. J., 2007, 28, p.: 1393–1396.
8. Puhringer, F. K., Kristen, P., Rex, C. Sugammadex reversal of rokuronium-induced neuromuscular block in Caesarean section patients: a series of seven cases. Br. J. Anaesth., 2010, 105,p.: 657–660.
9. Murdoch, H., Scrutton, M., Laxton, Ch. Choice of anaesthetic agents for caesarean section: A UK survey of current practice. Int. J. Obstet. Anesth., 2013, Jan. 22, 1, p.: 31–35, doi: 10.1016/j.ijoa.2012.09.001.
10. Státní ústav pro kontrolu léčiv 2013: SPC přípravku Bridion™ [citováno online 20. 2. 2013]. Dostupné z www: <http://www.sukl.cz/modules/medication/detail.php?code=0500226&tab=texts>
11. Williamson, R. M., Mallaiah, S., Barclay, P. Rokuronium and sugammadex for rapid sequence induction of obstetric general anaesthesia. Acta Anaesthesiol Scand., 2011, 55, p.: 694–699.
12. Státní ústav pro kontrolu léčiv 2013: SPC přípravku Esmeron™ [citováno online 20. 2. 2013]. Dostupné z www: <http://www.sukl.cz/modules/medication/detail.php?code=0031932&tab=texts >
13. Shibusawa, M., Ejima, Y., Nishino, R., Toyama, H.,Kurosawa, S. Use of sugammadex in patients undergoingcaesarean section using general anesthesia with rokuronium. Masui., 2012, Aug, 61, 8, p.: 805–809.
14. Nauheimer, D., Kollath, C., Geldner, G. Modified rapid sequence induction for Caesarian sections : case series on the use of rocuronium and sugammadex. Anaesthesist., 2012, Aug, 61, 8, p.: 691–695, doi: 10.1007/s00101-012-2065-6.
15. Llauradó, S., Sabaté, A., Ferreres, E., Camprubí, I., Cabrera, A.Sugammadex ideal body weight dose adjusted by level of neuromuscular blockade in laparoscopic bariatric surgery. Anesthesiology, 2012, Jul, 117, 1, p.: 93–98, doi: 10.1097/ALN.0b013e3182580409.
Štítky
Anaesthesiology, Resuscitation and Inten Intensive Care MedicineČlánok vyšiel v časopise
Anaesthesiology and Intensive Care Medicine
2013 Číslo 3
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