• A&A practice · May 2023

    Case Reports

    A Case Report of Acute Onset and Rapid Resolution of Atrioventricular Block After Sugammadex: Is the Autonomic System Involved?

    • Mohamed T Abdelrahim, Austin C Kassels, Cain W Stark, Christopher J Roberts, Julia A Vogt, and Thomas J Ebert.
    • Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin.
    • A A Pract. 2023 May 1; 17 (5): e01683e01683.

    AbstractAdministering sugammadex to reverse neuromuscular blockade can cause marked bradycardia and rarely asystole. In this case, a rapid onset, biphasic heart rate response; slowing then speeding, after administering sugammadex was noted while at steady state, 1.3% end-tidal sevoflurane. On review of the electrocardiogram (ECG), the heart rate slowing coincided with the onset of a second-degree, Mobitz type I block that lasted 45 seconds. No other events, drugs, or stimuli coincided with the event. The acute onset and transient nature of the atrioventricular block without evidence of ischemia implies a brief parasympathetic effect on the atrioventricular node after sugammadex administration.Copyright © 2023 International Anesthesia Research Society.

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