Kim Hyunho, Cho Joonho, Lee Sangseok, Lim Yunhee, Yoo Byunghoon
Department of Anesthesiology and Pain Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
Anesth Pain Med (Seoul). 2022 Jan;17(1):52-56. doi: 10.17085/apm.21071. Epub 2021 Oct 14.
Residual neuromuscular blockade (RNMB) is a frequent event after general anesthesia, which can lead to serious complications, such as upper airway obstruction. Sugammadex is useful in reversing RNMB. However, its use in infants has not yet been approved by the Food and Drug Administration. Therefore, anesthesiologists can be hesitant use it, even in situations where no other choice is available.
A two-month-old baby presented to the hospital for umbilical polypectomy. At the end of the surgery, neostigmine was administered. Even after waiting for 30 min and injecting an additional dose of neostigmine, neuromuscular blockade was not adequately reversed. Eventually, sugammadex was administered, and spontaneous breathing returned.
If there were no particular causes of delayed return to spontaneous breathing in infants, RNMB should be considered and reversal with sugammadex would be useful.
残余肌松（RNMB）是全身麻醉后常见的情况，可导致严重并发症，如气道梗阻。舒更葡糖钠在逆转RNMB方面很有用。然而，其在婴儿中的使用尚未获得美国食品药品监督管理局的批准。因此，即使在没有其他选择的情况下，麻醉医生也可能会犹豫是否使用它。
一名两个月大的婴儿因脐息肉切除术入院。手术结束时，给予了新斯的明。即使等待30分钟并额外注射一剂新斯的明后，肌松仍未得到充分逆转。最终，给予了舒更葡糖钠，自主呼吸恢复。
如果婴儿自主呼吸恢复延迟没有特殊原因，应考虑存在RNMB，使用舒更葡糖钠进行逆转可能会有帮助。
