Intractable Neuromuscular Blockade Resistant to Sugammadex Rescue Administration: A Case Report

We describe the failure of sugammadex when used as a rescue agent, after neuromuscular blockade with rocuronium was insufficiently reversed with neostigmine and glycopyrrolate. Despite repeated doses, this patient needed to be reintubated and sedated until spontaneous recovery was observed over the next few hours. With the increasing preference to utilize sugammadex in the perioperative setting, we are starting to notice a significant number of patients displaying residual paralysis despite sugammadex administration as a solo or rescue agent at our institution. We believe that more attention is needed to examine the factors that contribute to insufficient neuromuscular blockade reversal in these settings.