Suggamadeks ile Başarılı Revers Edilen Rokuronyuma Bağlı Bilateral Nonreaktif Fiks Dilate Pupil: Olgu Sunumu ve Literatürün Gözden Geçirilmesi

Abstract

Coronavirus disease-2019 (COVID-19) is a serious infectious disease, which may cause various clinical conditions ranging from asymptomatic cases to severe complications like acute respiratory distress syndrome (ARDS) and even to death. Although there are some differences between COVID-19-associated ARDS and conventional ARDS, mortality is still high. Infusion of a non-depolarizing muscle relaxant is recommended in ARDS patients with a PaO2/FiO2 ratio <100. Rocuronium is a non-depolarizing muscle relaxant, which cannot cross the blood-brain barrier. Therefore, side effects related to the central nervous system are not expected. However, rocuronium may penetrate the central nervous system in patients with disrupted bloodbrain barrier and there are a few case reports in the literature with rocuronium-associated fixed and dilated non-reactive pupils. This is a very rare condition. In this case report, we present a COVID-19 patient, who had bilateral dilated and non-reactive pupils that was related to rocuronium infusion and reversed with sugammadex.