[A Case of Anaphylactic Shock Immediately after Administration of Sugammadex].

We experienced a case of 82-years-old-man who developed anaphylactic shock immediately after admin- istration of sugammadex. He was scheduled for ventral hernia surgery. Anesthesia was induced by propofol, rocuronium and remifentanil, and maintained with des- flurane, remifentanil and intermittent rocuronium. Intraoperative course was stable. After the operation, sugammadex was administered. After 3 minutes, hypo- tension with tachycardia developed. We administered ephedrine, but it was not effective. Then, wheal with redness also appeared over the trunk and limbs. We considered anaphylactic shock caused by sugammadex, and immediately administered adrenaline and cortico- steroid. In addition rapid volume load of crystalloid solution 500 ml was given. His hemodynamics recov- ered, and wheal with redness also disappeared gradu- ally. His respiratory state was stable and he was extubated. After administration of methylpredniso- lone, he was transferred to the surgical ward and showed no troubles thereafter. Anaphylaxis caused by sugammadex is a rare event However, considering the high frequency of sugamma- dex use in Japan, we should always keep the possibil- ity of anaphylactic shock caused by sugammadex in mind during daily general anesthetic management.