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Updated: May 19, 2026
04:46
A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
Published on: January 17, 2011
[Difficult ventilation after sugammadex administration: a case report]
Kazuhiko Hasegawa1, Masaharu Kinoshita, Takehisa Asahi
1Department of Anesthesia, Nishinomiya Kyoritsu Neurosurgical Hospital, Nishinomiya.
Masui. the Japanese Journal of Anesthesiology
|August 7, 2012
Summary
Sugammadex rapidly reversed neuromuscular blockade, causing difficult ventilation due to fentanyl
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- A 71-year-old woman underwent arthroscopic knee surgery under sevoflurane, fentanyl, and rocuronium bromide anesthesia.
- Fentanyl (200 microg) and rocuronium bromide (40mg) were administered.
- Sugammadex (150 mg) was given post-operatively to reverse neuromuscular blockade.
Observation:
- Immediately after sugammadex administration, airway pressure increased to 37 cmH20, leading to difficult ventilation.
- A subsequent naloxone (0.1 mg) injection dramatically improved ventilation.
- The event suggests a potential reaction to fentanyl causing upper airway reflex or muscle rigidity.
Findings:
- Sugammadex administration precipitated acute respiratory distress.
- Naloxone administration rapidly resolved the respiratory distress.
- The findings highlight a potential interaction between fentanyl and sugammadex.
Implications:
- Rapid reversal of neuromuscular blockade with sugammadex may unmask or exacerbate fentanyl-induced respiratory complications.
- Careful patient assessment and monitoring of anesthetic effects are crucial before sugammadex administration.
- This case underscores the importance of considering opioid-induced effects during neuromuscular blockade reversal.
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