A confirmed case of sugammadex-induced anaphylaxis in a UK hospital

O'Donnell, R. , Hammond, J. and Soltanifar, S. (2017) A confirmed case of sugammadex-induced anaphylaxis in a UK hospital. BMJ Case Reports, 2017, (doi: 10.1136/bcr-2017-220197) (PMID:28501827)

Abstract

We report the first published case of confirmed anaphylaxis to sugammadex in a UK hospital. The patient was given a bolus of sugammadex at the end of surgery. Four minutes later, he developed hypotension and a widespread erythematous rash. Multiple epinephrine boluses were administered and a continuous intravenous infusion of epinephrine commenced. The patient later reported auditory awareness, which occurred while the diagnosis of anaphylaxis was being made and initial treatment initiated. Serial serum tryptase levels were consistent with a type I hypersensitivity reaction. Skin prick and intradermal testing were performed 6 months later confirming allergy to sugammadex. This case restates the potential for hypersensitivity reactions to develop following the administration of sugammadex and makes clinicians aware that such reactions may require prolonged treatment with intravenous infusions of epinephrine. Finally, this case highlights the importance of maintaining or re-establishing anaesthesia while managing the emergent situation in order to avoid unintentional awareness.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: O'Donnell, Dr Robert
• Authors: O'Donnell, R., Hammond, J., and Soltanifar, S.
• College/School: College of Medical Veterinary and Life Sciences
• Journal Name: BMJ Case Reports
• Publisher: BMJ Publishing Group
• ISSN: 1757-790X
• ISSN (Online): 1757-790X
• Copyright Holders: Copyright © 2017 BMJ Publishing Group
• First Published: First published in BMJ Case Reports 2017
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher