A rare case of atropine-resistant bradycardia following sugammadex administration
Abstract Background Profound bradycardia caused by sugammadex has been reported, although its mechanism is unclear. Herein, we suggest a possible culprit for this phenomenon. Case presentation A 50-year-old woman without comorbidity except mild obesity underwent a transabdominal hysterectomy and rig...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2020-03-01
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| Series: | JA Clinical Reports |
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| Online Access: | http://link.springer.com/article/10.1186/s40981-020-00326-7 |
| _version_ | 1818434446928379904 |
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| author | Takayuki Yoshida Chisato Sumi Takeo Uba Haruka Miyata Takeshi Umegaki Takahiko Kamibayashi |
| author_facet | Takayuki Yoshida Chisato Sumi Takeo Uba Haruka Miyata Takeshi Umegaki Takahiko Kamibayashi |
| author_sort | Takayuki Yoshida |
| collection | DOAJ |
| description | Abstract Background Profound bradycardia caused by sugammadex has been reported, although its mechanism is unclear. Herein, we suggest a possible culprit for this phenomenon. Case presentation A 50-year-old woman without comorbidity except mild obesity underwent a transabdominal hysterectomy and right salpingo-oophorectomy. After surgery, sugammadex 200 mg was intravenously administered. Approximately 4 min later, her heart rate decreased to 36 bpm accompanied by hypotension (41/20 mmHg) and ST depression in limb lead electrocardiogram (ECG). Atropine 0.5 mg was injected intravenously without improving the hemodynamics. Intravenous adrenaline 0.5 mg was added despite the lack of signs suggesting allergic reactions. Her heart rate and blood pressure quickly recovered and remained stable thereafter, although 12-lead ECG taken 1 h later still showed ST depression. Conclusions In this case, the significant bradycardia appeared attributable to coronary vasospasm (Kounis syndrome) induced by sugammadex, considering the ECG findings and high incidence of anaphylaxis due to sugammadex. |
| first_indexed | 2024-12-14T16:37:08Z |
| format | Article |
| id | doaj.art-de3b8d77874a4a66a896fe45fba5a8c2 |
| institution | Directory Open Access Journal |
| issn | 2363-9024 |
| language | English |
| last_indexed | 2024-12-14T16:37:08Z |
| publishDate | 2020-03-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | JA Clinical Reports |
| spelling | doaj.art-de3b8d77874a4a66a896fe45fba5a8c22022-12-21T22:54:25ZengSpringerOpenJA Clinical Reports2363-90242020-03-01611510.1186/s40981-020-00326-7A rare case of atropine-resistant bradycardia following sugammadex administrationTakayuki Yoshida0Chisato Sumi1Takeo Uba2Haruka Miyata3Takeshi Umegaki4Takahiko Kamibayashi5Department of Anesthesiology, Kansai Medical University HospitalDepartment of Anesthesiology, Chibune General HospitalDepartment of Anesthesiology, Kansai Medical University HospitalDepartment of Anesthesiology, Baba Memorial HospitalDepartment of Anesthesiology, Kansai Medical University HospitalDepartment of Anesthesiology, Kansai Medical University HospitalAbstract Background Profound bradycardia caused by sugammadex has been reported, although its mechanism is unclear. Herein, we suggest a possible culprit for this phenomenon. Case presentation A 50-year-old woman without comorbidity except mild obesity underwent a transabdominal hysterectomy and right salpingo-oophorectomy. After surgery, sugammadex 200 mg was intravenously administered. Approximately 4 min later, her heart rate decreased to 36 bpm accompanied by hypotension (41/20 mmHg) and ST depression in limb lead electrocardiogram (ECG). Atropine 0.5 mg was injected intravenously without improving the hemodynamics. Intravenous adrenaline 0.5 mg was added despite the lack of signs suggesting allergic reactions. Her heart rate and blood pressure quickly recovered and remained stable thereafter, although 12-lead ECG taken 1 h later still showed ST depression. Conclusions In this case, the significant bradycardia appeared attributable to coronary vasospasm (Kounis syndrome) induced by sugammadex, considering the ECG findings and high incidence of anaphylaxis due to sugammadex.http://link.springer.com/article/10.1186/s40981-020-00326-7SugammadexBradycardiaCardiac arrestAnaphylaxisCoronary vasospasmKounis syndrome |
| spellingShingle | Takayuki Yoshida Chisato Sumi Takeo Uba Haruka Miyata Takeshi Umegaki Takahiko Kamibayashi A rare case of atropine-resistant bradycardia following sugammadex administration JA Clinical Reports Sugammadex Bradycardia Cardiac arrest Anaphylaxis Coronary vasospasm Kounis syndrome |
| title | A rare case of atropine-resistant bradycardia following sugammadex administration |
| title_full | A rare case of atropine-resistant bradycardia following sugammadex administration |
| title_fullStr | A rare case of atropine-resistant bradycardia following sugammadex administration |
| title_full_unstemmed | A rare case of atropine-resistant bradycardia following sugammadex administration |
| title_short | A rare case of atropine-resistant bradycardia following sugammadex administration |
| title_sort | rare case of atropine resistant bradycardia following sugammadex administration |
| topic | Sugammadex Bradycardia Cardiac arrest Anaphylaxis Coronary vasospasm Kounis syndrome |
| url | http://link.springer.com/article/10.1186/s40981-020-00326-7 |
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