Three suspected cases of sugammadex-induced anaphylactic shock

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• 作者：Tomonori Takazawa (1)
  Yukinari Tomita (2)
  Nagahide Yoshida (3)
  Akihiro Tomioka (4)
  Tatsuo Horiuchi (1)
  Chie Nagata (1)
  Masaki Orihara (1)
  Makiko Hardy Yamada (1)
  Shigeru Saito (1)
  
  1. Department of Anesthesiology ; Gunma University Graduate School of Medicine ; 3-39-22 Showa-machi ; Maebashi ; 371-8511 ; Japan
  2. Department of Anesthesiology ; Isesaki Municipal Hospital ; 12-1 Tsunatorihoncho ; Isesaki ; 372-0817 ; Japan
  3. Department of Anesthesiology ; Saiseikai Maebashi Hospital ; 564-1 Kamishinden-machi ; Maebashi ; 971-0821 ; Japan
  4. Department of Anesthesiology ; Gunma Chuo General Hospital ; 1-7-13 Kouuncho ; Maebashi ; 371-0025 ; Japan
  
• 关键词：Sugammadex ; Anaphylactic shock ; General anesthesia
• 刊名：BMC Anesthesiology
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：14
• 期：1
• 全文大小：230 KB
• 参考文献：1. Paton, F, Paulden, M, Chambers, D, Heirs, M, Duffy, S, Hunter, JM, Sculpher, M, Woolacott, N (2010) Sugammadex compared with neostigmine/glycopyrrolate for routine reversal of neuromuscular block: a systematic review and economic evaluation. Br J Anaesth 105: pp. 558-567 CrossRef
  2. Cammu, G, De Kam, PJ, Demeyer, I, Decoopman, M, Peeters, PA, Smeets, JM, Foubert, L (2008) Safety and tolerability of single intravenous doses of sugammadex administered simultaneously with rocuronium or vecuronium in healthy volunteers. Br J Anaesth 100: pp. 373-379 CrossRef
  3. Godai, K, Hasegawa-Moriyama, M, Kuniyoshi, T, Kakoi, T, Ikoma, K, Isowaki, S, Matsunaga, A, Kanmura, Y (2012) Three cases of suspected sugammadex-induced hypersensitivity reactions. Br J Anaesth 109: pp. 216-218 CrossRef
  4. Menendez-Ozcoidi, L, Ortiz-Gomez, JR, Olaguibel-Ribero, JM, Salvador-Bravo, MJ (2011) Allergy to low dose sugammadex. Anaesthesia 66: pp. 217-219 CrossRef
  5. Motoyama, Y, Izuta, S, Maekawa, N, Chuma, R (2012) [Case of anaphylactic reaction caused by sugammadex]. Masui 61: pp. 746-748
  6. Peeters, PA, van den Heuvel, MW, van Heumen, E, Passier, PC, Smeets, JM, van Iersel, T, Zwiers, A (2010) Safety, tolerability and pharmacokinetics of sugammadex using single high doses (up to 96聽mg/kg) in healthy adult subjects: a randomized, double-blind, crossover, placebo-controlled, single-centre study. Clin Drug Investig 30: pp. 867-874 CrossRef
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  8. Jeyadoss, J, Kuruppu, P, Nanjappa, N, Van Wijk, R (2014) Sugammadex hypersensitivity-a case of anaphylaxis. Anaes Intens Care 42: pp. 89-92
  9. Dewachter, P, Mouton-Faivre, C, Emala, CW (2009) Anaphylaxis and anesthesia: controversies and new insights. Anesthesiology 111: pp. 1141-1150 CrossRef
  10. Sampson, HA, Munoz-Furlong, A, Campbell, RL, Adkinson, NF, Bock, SA, Branum, A, Brown, SG, Camargo, CA, Cydulka, R, Galli, SJ, Gidudu, J, Gruchalla, RS, Harlor, AD, Hepner, DL, Lewis, LM, Lieberman, PL, Metcalfe, DD, O'Connor, R, Muraro, A, Rudman, A, Schmitt, C, Scherrer, D, Simons, FE, Thomas, S, Wood, JP, Decker, WW (2006) Second symposium on the definition and management of anaphylaxis: summary report鈥揝econd National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium. J Allergy Clin Immunol 117: pp. 391-397 CrossRef
  11. Harper, NJ, Dixon, T, Dugue, P, Edgar, DM, Fay, A, Gooi, HC, Herriot, R, Hopkins, P, Hunter, JM, Mirakian, R, Pumphrey, RS, Seneviratne, SL, Walls, AF, Williams, P, Wildsmith, JA, Wood, P, Nasser, AS, Powell, RK, Mirakhur, R, Soar, J (2009) Suspected anaphylactic reactions associated with anaesthesia. Anaesthesia 64: pp. 199-211 CrossRef
  12. Mertes, PM, Laxenaire, MC, Alla, F (2003) Anaphylactic and anaphylactoid reactions occurring during anesthesia in France in 1999-2000. Anesthesiology 99: pp. 536-545 CrossRef
  13. Dewachter, P, Mouton-Faivre, C (2008) What investigation after an anaphylactic reaction during anaesthesia?. Curr Opin Anesthesio 21: pp. 363-368 CrossRef
  14. Fisher, M, Baldo, BA (1994) Anaphylaxis during anaesthesia: current aspects of diagnosis and prevention. Eur J Anaesthesiol 11: pp. 263-284
  15. Clarke, RC, Sadleir, PH, Platt, PR (2012) The role of sugammadex in the development and modification of an allergic response to rocuronium: evidence from a cutaneous model. Anaesthesia 67: pp. 266-273 CrossRef
  16. Ewan, PW, Dugue, P, Mirakian, R, Dixon, TA, Harper, JN, Nasser, SM (2010) BSACI guidelines for the investigation of suspected anaphylaxis during general anaesthesia. Clin Exper allergy 40: pp. 15-31 CrossRef
  17. Kroigaard, M, Garvey, LH, Gillberg, L, Johansson, SG, Mosbech, H, Florvaag, E, Harboe, T, Eriksson, LI, Dahlgren, G, Seeman-Lodding, H, Takala, R, Wattwil, M, Hirlekar, G, Dahl茅n, B, Guttormsen, AB (2007) Scandinavian Clinical Practice Guidelines on the diagnosis, management and follow-up of anaphylaxis during anaesthesia. Acta anaesthesiologica Scandinavica 51: pp. 655-670 CrossRef
  18. Kotake, Y, Ochiai, R, Suzuki, T, Ogawa, S, Takagi, S, Ozaki, M, Nakatsuka, I, Takeda, J (2013) Reversal with sugammadex in the absence of monitoring did not preclude residual neuromuscular block. Anesth Analg 117: pp. 345-351 CrossRef
  19. Mertes, PM, Malinovsky, JM, Jouffroy, L, Aberer, W, Terreehorst, I, Brockow, K, Demoly, P (2011) Reducing the risk of anaphylaxis during anesthesia: 2011 updated guidelines for clinical practice. Journal Invest Allergology Clinical Immun 21: pp. 442-453
  20. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2253/14/92/prepub
  
• 刊物主题：Anesthesiology; Internal Medicine; Emergency Medicine; Intensive / Critical Care Medicine;
• 出版者：BioMed Central
• ISSN：1471-2253

文摘

Background Sugammadex has a unique mechanism of action and is widely used because of its safety and efficacy. A few recent reports have described allergic reactions to clinical doses of sugammadex. We hereby describe another series of cases of possible anaphylaxis to sugammadex. Case presentation We present three suspected cases of sugammadex-induced anaphylactic shock, including a 13-year-old boy who underwent laparoscopic appendectomy, a 75-year-old woman who underwent left knee arthroplasty, and a 34-year-old man who underwent left pansinectomy for sinobronchitis. All three patients received general anesthesia with rocuronium and their tracheas were intubated. Shortly after injection of sugammadex for reversal of rocuronium, all of them experienced a decrease in blood pressure along with mucocutaneous erythema. In the most severe case, reintubation after extubation was required due to difficulty in manual ventilation. All patients recovered with anti-allergic therapy. On later investigation, all three patients had a positive skin reaction to sugammadex. Conclusion Our results suggest that physicians using sugammadex should be aware of the possibility of sugammadex-induced anaphylaxis.