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Journal of Anesthesia
Published in: Journal of Anesthesia 2/2016

Open Access 01-04-2016 | Invited Review Article

Sugammadex and rocuronium-induced anaphylaxis

Authors: Tomonori Takazawa, Hiromasa Mitsuhata, Paul Michel Mertes

Published in: Journal of Anesthesia | Issue 2/2016

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Abstract

Perioperative anaphylaxis is a life-threatening clinical condition that is typically the result of drugs or substances used for anesthesia or surgery. The most common cause of anaphylaxis during anesthesia is reportedly neuromuscular blocking agents. Of the many muscle relaxants that are clinically available, rocuronium is becoming popular in many countries. Recent studies have demonstrated that succinylcholine (but also rocuronium use) is associated with a relatively high rate of IgE-mediated anaphylaxis compared with other muscle relaxant agents. Sugammadex is widely used for reversal of the effects of steroidal neuromuscular blocking agents, such as rocuronium and vecuronium. Confirmed cases of allergic reactions to clinical doses of sugammadex have also been recently reported. Given these circumstances, the number of cases of hypersensitivity to either sugammadex or rocuronium is likely to increase. Thus, anesthesiologists should be familiar with the epidemiology, mechanisms, and clinical presentations of anaphylaxis induced by these drugs. In this review, we focus on the diagnosis and treatment of anaphylaxis to sugammadex and neuromuscular blocking agents. Moreover, we discuss recent studies in this field, including the diagnostic utility of flow cytometry and improvement of rocuronium-induced anaphylaxis with the use of sugammadex.
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Metadata
Title
Sugammadex and rocuronium-induced anaphylaxis
Authors
Tomonori Takazawa
Hiromasa Mitsuhata
Paul Michel Mertes
Publication date
01-04-2016
Publisher
Springer Japan
Published in
Journal of Anesthesia / Issue 2/2016
Print ISSN: 0913-8668
Electronic ISSN: 1438-8359
DOI
https://doi.org/10.1007/s00540-015-2105-x

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