Repeated sugammadex reversal of muscle relaxation during lumbar spine surgery with intraoperative neurophysiological multimodal monitoring

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• 作者：C.L. Errando^a ; ^{errando013@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; T. Blanco^b ; Ó ; . Dí ; az-Cambronero^c
• 关键词：Spine surgery ; Intraoperative neurophysiological monitoring ; Anesthesia ; Neuromuscular blocking drugs ; Rocuronium ; Sugammadex
• 刊名：Revista Española de Anestesiología y Reanimación
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：63
• 期：9
• 页码：533-538
• 全文大小：856 K

文摘

Intraoperative neurophysiological monitoring during spine surgery is usually acomplished avoiding muscle relaxants. A case of intraoperative sugammadex partial reversal of the neuromuscular blockade allowing adequate monitoring during spine surgery is presented.

A 38 year-old man was scheduled for discectomy and vertebral arthrodesis throughout anterior and posterior approaches. Anesthesia consisted of total intravenous anesthesia plus rocuronium. Intraoperatively monitoring was needed, and the muscle relaxant reverted twice with low dose sugammadex in order to obtain adequate responses.

The doses of sugammadex used were conservatively selected (0.1 mg/kg boluses increases, total dose needed 0.4 mg/kg). Both motor evoqued potentials, and electromyographic responses were deemed adequate by the neurophysiologist.

If muscle relaxation was needed in the context described, this approach could be useful to prevent neurological sequelae. This is the first study using very low dose sugammadex to reverse rocuronium intraoperatively and to re-establish the neuromuscular blockade.