Takazawa Tomonori, Tomita Yukinari, Yoshida Nagahide, Tomioka Akihiro, Horiuchi Tatsuo, Nagata Chie, Orihara Masaki, Yamada Makiko Hardy, Saito Shigeru
Department of Anesthesiology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, 371-8511 Japan.
Department of Anesthesiology, Isesaki Municipal Hospital, 12-1 Tsunatorihoncho, Isesaki, 372-0817 Japan.
BMC Anesthesiol. 2014 Oct 17;14:92. doi: 10.1186/1471-2253-14-92. eCollection 2014.
Sugammadex has a unique mechanism of action and is widely used because of its safety and efficacy. A few recent reports have described allergic reactions to clinical doses of sugammadex. We hereby describe another series of cases of possible anaphylaxis to sugammadex.
We present three suspected cases of sugammadex-induced anaphylactic shock, including a 13-year-old boy who underwent laparoscopic appendectomy, a 75-year-old woman who underwent left knee arthroplasty, and a 34-year-old man who underwent left pansinectomy for sinobronchitis. All three patients received general anesthesia with rocuronium and their tracheas were intubated. Shortly after injection of sugammadex for reversal of rocuronium, all of them experienced a decrease in blood pressure along with mucocutaneous erythema. In the most severe case, reintubation after extubation was required due to difficulty in manual ventilation. All patients recovered with anti-allergic therapy. On later investigation, all three patients had a positive skin reaction to sugammadex.
Our results suggest that physicians using sugammadex should be aware of the possibility of sugammadex-induced anaphylaxis.
舒更葡糖钠具有独特的作用机制，因其安全性和有效性而被广泛使用。最近有一些报告描述了对临床剂量舒更葡糖钠的过敏反应。我们在此描述另一系列可能对舒更葡糖钠发生过敏反应的病例。
我们报告了3例疑似舒更葡糖钠引起的过敏性休克病例，包括1例接受腹腔镜阑尾切除术的13岁男孩、1例接受左膝关节置换术的75岁女性和1例因鼻窦支气管炎接受左全肺切除术的34岁男性。所有3例患者均接受了罗库溴铵全身麻醉并进行气管插管。在注射舒更葡糖钠用于逆转罗库溴铵作用后不久，他们均出现血压下降并伴有皮肤黏膜红斑。在最严重的病例中，由于手动通气困难，拔管后需要重新插管。所有患者经抗过敏治疗后康复。在后续调查中，所有3例患者对舒更葡糖钠的皮肤反应均呈阳性。
我们的结果表明，使用舒更葡糖钠的医生应意识到舒更葡糖钠引起过敏反应的可能性。
