Sakai Yoko, Tsutsumi Yasuo M, Wakamatsu Narutomo, Soga Tomohiro, Tanaka Katsuya, Oshita Shuzo
Department of Anesthesiology, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan.
J Med Invest. 2011 Feb;58(1-2):163-5. doi: 10.2152/jmi.58.163.
We present a case where immediate muscle relaxation was needed following sugammadex administration. A 72 year-old female underwent surgery for a cerebral artery aneurysm. Upon conclusion of the operation sugammadex (9.3 mg/kg) was administered and the patient was noted to have left hemiplegia. Rocuronium (1.2 mg/kg × 2 doses) was given in order to gain neuromuscular block approximately 25 minutes after sugammadex had been injected. Although TOF monitoring was not utilized in this case and assessing residual muscular block was difficult, spontaneous respirations continued and breathing had to be controlled with sevoflurane and remifentanil. Sugammadex is a potent reversal agent for rocuronium-induced neuromuscular block, however, certain situations require immediate neuromuscular blockade following sugammadex. In this case, rocuronium was unable to induce neuromuscular blockade immediately after sugammadex and that higher concentrations were necessary in addition to intravenous analgesics and inhaled anesthetics.
我们报告了一例在给予舒更葡糖后需要立即实现肌肉松弛的病例。一名72岁女性接受了脑动脉瘤手术。手术结束后给予舒更葡糖（9.3毫克/千克），发现患者出现左半身麻痹。在注射舒更葡糖约25分钟后，为了实现神经肌肉阻滞给予罗库溴铵（1.2毫克/千克×2剂）。尽管该病例未使用强直刺激比值（TOF）监测且评估残余肌松困难，但患者自主呼吸持续存在，必须使用七氟醚和瑞芬太尼控制呼吸。舒更葡糖是罗库溴铵诱导的神经肌肉阻滞的有效逆转剂，然而，某些情况下在给予舒更葡糖后需要立即进行神经肌肉阻滞。在此病例中，舒更葡糖给药后罗库溴铵无法立即诱导神经肌肉阻滞，除静脉镇痛药和吸入麻醉药外还需要更高浓度的罗库溴铵。
