• Br J Anaesth · Aug 2012

    Case Reports

    Three cases of suspected sugammadex-induced hypersensitivity reactions.

    A reminder that hypersensitivity reactions are possible with almost any drug or chemical. At the time of this publication, the risk of anaphylaxis to sugammadex appeared to be lower than that for muscle relaxants – however newer studies from Merck (Kam 2018 and Min 2018) worryingly suggest that sugammadex sensitivity may be a lot more common than we thought.

    The FDA’s caution now no longer seems quite so unwarranted...

    summary
    • K Godai, M Hasegawa-Moriyama, T Kuniyoshi, T Kakoi, K Ikoma, S Isowaki, A Matsunaga, and Y Kanmura.
    • Department of Anaesthesiology and Critical Care Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan.
    • Br J Anaesth. 2012 Aug 1;109(2):216-8.

    AbstractNeuromuscular blocking agents have been implicated in 60-70% of anaphylactic events associated with anaesthesia. We report two cases of probable hypersensitivity reaction to sugammadex and an additional suspected but less supported case of possible immune-mediated reaction or other adverse reaction. The patients were given a bolus of sugammadex 100 mg immediately before extubation. In all three patients, a possible allergic reaction was suspected within 4 min of sugammadex administration, but with different degrees of severity. Skin testing was positive in two of these patients. Hypersensitivity to sugammadex unaccompanied by cardiovascular or respiratory symptoms might be missed during the course of anaesthesia. Careful monitoring for possible allergic responses is required in patients who have received sugammadex.

      Pubmed     Free full text  

      Add institutional full text...

    This article appears in the collections: Sugammadex anaphylaxis: all that glitters? and Is sugammadex as good as we think?.

    Notes

    summary
    1

    A reminder that hypersensitivity reactions are possible with almost any drug or chemical. At the time of this publication, the risk of anaphylaxis to sugammadex appeared to be lower than that for muscle relaxants – however newer studies from Merck (Kam 2018 and Min 2018) worryingly suggest that sugammadex sensitivity may be a lot more common than we thought.

    The FDA’s caution now no longer seems quite so unwarranted...

    Daniel Jolley  Daniel Jolley
    comment
    0

    Concerns regarding hypersensitivity to sugammadex are reportedly one of the primary sticking points for sugammadex still lacking FDA approval.

    Daniel Jolley  Daniel Jolley
     
    Do you have a pearl, summary or comment to save or share?
    250 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…