General Anesthesia for Electroconvulsive Therapy in a Patient With Systemic Mastocytosis

Sugammadex in systemic mastocytosis

“…In 4 case reports of patients with systemic mastocytosis the use of sugammadex is reported [ 8 – 11 ]. Two articles justify not using of sugammadex due to its unavailability [ 12 , 13 ]. In another article, sugammadex is proposed as an acceptable option in pregnant women with mastocytosis, although in the reported case neuraxial anesthesia was used [ 14 ].…”

“…This reaction occurs even in patients without sensitization to this agent, provoking pseudoallergic (nonanaphylactic) reactions [ 5 ]. Thus, some authors recommend avoiding it [ 16 , 22 – 27 ]; however, other authors recommend using it as an alternative to others that release even more histamine, such as atracurium or succinylcholine [ 6 , 12 , 28 – 32 ]. The administration of sugammadex has been shown to prevent rocuronium from interacting with the immune system, but anaphylactic reactions induced by rocuronium cannot be completely abolished by sugammadex [ 33 ].…”

“…(2020) [ 11 ] Used Used Yes, perioperatively Case report: Scheduled neurosurgery Bryson et al. (2017) [ 12 ] Used Not available No Case report: electroconvulsive therapy Aloysi et al. (2016) [ 13 ] Acceptable alternative (not used) Not available No Case report: electroconvulsive therapy Kumaraswami et al.…”