Abstract
In rare cases, rocuronium has been associated with dose-related tachycardia, probably by a cardiac muscarinic M2 receptor blockade mechanism. We report the case of a 30-year-old female who underwent excision of a branchial cyst under general anesthesia. This patient presented an episode of sinus tachycardia (130 bpm) shortly after anesthesia induction with propofol, sufentanyl, and rocuronium. Tachycardia could not be explained by any cause other than the use of rocuronium, which was reverted with sugammadex. Two minutes after sugammadex administration, heart rate normalized, corroborating our hypothesis that rocuronium induced the sinus tachycardia observed in our patient. The patient recovered well from the anesthetic-surgical procedure and showed no further cardiovascular, ventilatory, or neurological changes, being transferred to the post-anesthesia care unit, and finally discharged to the ward.
Highlights
The introduction of neuromuscular blocking agents (NBA) to anesthetic practice allowed great advance in airway management and helped to optimize the surgical field by inhibiting spontaneous ventilation and causing relaxation of skeletal muscles
We report a case of sinus tachycardia following anesthesia induction in which tachycardia could not be explained by any cause other than the use of rocuronium
Heart rate normalized after administration of sugammadex, a modified gamma-cyclodextrin indicated to reverse neuromuscular blockade produced by rocuronium
Summary
The introduction of neuromuscular blocking agents (NBA) to anesthetic practice allowed great advance in airway management and helped to optimize the surgical field by inhibiting spontaneous ventilation and causing relaxation of skeletal muscles. Its use in anesthesia is increasing due to the possibility of its application in rapid sequence endotracheal intubation and due to existence of an effective reverser. (2014) Sugammadex in the Management of Sinus Tachycardia after Rocuronium Administration: A Case Report. We report a case of sinus tachycardia following anesthesia induction in which tachycardia could not be explained by any cause other than the use of rocuronium. Heart rate normalized after administration of sugammadex, a modified gamma-cyclodextrin indicated to reverse neuromuscular blockade produced by rocuronium
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