Intraoperative Severe Anaphylactic Shock to Sugammadex in an Anesthesia-Naïve Patient

Sugammadex is a revolutionary drug for the reversal of neuromuscular blocking agents (NMBAs). It is a modified gamma cyclodextrin that directly binds and inactivates steroidal nondepolarizing neuromuscular blockers to facilitate reversal with fewer adverse effects than previously used reversal agents. In general, literature supports its favorable safety profile, with common side effects being nausea, vomiting, headache, dry mouth, and dizziness. Sugammadex may also cause hypotension, bradycardia, or, rarely, anaphylaxis. The present case describes the clinical presentation and management of severe anaphylactic shock following intraoperative sugammadex administration to an anesthesia-naïve patient.