2021
DOI: 10.4103/joacp.joacp_383_19
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Sugammadex and anaphylaxis

Abstract: In this study, the published sugammadex-induced anaphylaxis reports were reviewed to determine similarities in their presentation during anesthesia. PubMed was searched for sugammadex-induced anaphylaxis without time limitation. Reports were evaluated if they were in English and met the criteria of anaphylaxis determined by the World Allergy Organization. Two independent reviewers extracted and assessed the data using predesigned data collection forms. In total, 23 suitable articles were found and 33 sugammade… Show more

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Cited by 16 publications
(25 citation statements)
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“…Moreover, sugammadex alone has been reported to be associated with allergic reactions. 8 In conclusion, we report here a rare case of severe rocuronium-induced anaphylaxis that was successfully treated with sugammadex in a patient with possible crossreactivity to cisatracurium. This case highlights the potential beneficial effect of sugammadex as an adjunct to conventional measures during rocuronium-induced anaphylaxis.…”
Section: Discussionmentioning
confidence: 70%
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“…Moreover, sugammadex alone has been reported to be associated with allergic reactions. 8 In conclusion, we report here a rare case of severe rocuronium-induced anaphylaxis that was successfully treated with sugammadex in a patient with possible crossreactivity to cisatracurium. This case highlights the potential beneficial effect of sugammadex as an adjunct to conventional measures during rocuronium-induced anaphylaxis.…”
Section: Discussionmentioning
confidence: 70%
“…11 The clinical manifestation of perioperative anaphylaxis is diverse and ranges from mild to severe symptoms which can include cutaneous, respiratory, circulatory and central nervous changes, including cardiac arrest. 8,14 A fourgrade severity scale has been used to categorise the degree of the anaphylactic reaction: grade 1, anaphylaxis with cutaneous signs; grade 2, anaphylaxis with measurable but not life-threatening symptoms, including cardiovascular reaction (tachycardia, hypotension), gastrointestinal disturbance (nausea) and respiratory disturbance (cough or mechanical ventilation difficulty); grade 3, anaphylaxis with life-threatening reactions, including severe bronchospasm or cardiovascular collapse; grade 4, anaphylaxis with cardiac and/or respiratory arrest. [15][16][17][18][19][20][21] In this present case, the patient developed grade 4 anaphylaxis following rocuronium administration.…”
Section: Discussionmentioning
confidence: 99%
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“…Despite the potential utility of sugammadex in this clinical scenario, its use should be considered carefully, and the risk–benefit ratio determined. Sugammadex itself can cause allergic reactions, the incidence of which is only now being recognized and investigated 34,35 . Sugammadex binds aminosteroid molecules, and there is the potential for sugammadex to bind other steroid molecules including hydrocortisone which may have undesirable physiologic effects, especially in the setting of an allergic reaction.…”
Section: Discussionmentioning
confidence: 99%
“…Sugammadex itself can cause allergic reactions, the incidence of which is only now being recognized and investigated. 34,35 Sugammadex binds aminosteroid molecules, and there intravenous fluids, bronchodilators, corticosteroids, and antihistamines. 5,6,36,37 A systematic approach is necessary for the diagnosis of an intraoperative allergic reaction, confirmation of the offending agent, its management under anesthesia, and the process for appropriate postoperative laboratory and skin testing to guide future anesthetic care.…”
Section: Discussionmentioning
confidence: 99%