Bilateral Non-Reactive Fixed and Dilated Pupils Caused by Rocuronium and Successfully Reversed with Sugammadex: A Case Report and Literature Review

Abstract

Coronavirus disease-2019 (COVID-19) is a serious viral infection, which may cause various clinical conditions ranging from mild-to-moderate symptoms to fatal consequences. 1 Rocuronium is a neuromuscular blocking agent (NMBA). It is widely used in general anesthesia and also recommended as an infusion therapy in patients with acute respiratory distress syndrome (ARDS), who require intensive respiratory support. 2 Although fixed and dilated pupils were mentioned in a few case reports, it was considered as not a very frequent side effect of rocuronium. 3,4 In this case report, we presented a patient, who was treated with rocuronium infusion due to the COVID-19 related ARDS and developed bilateral fixed and dilated pupils.