Han Woong, Lee Jong Min, Park Dong Ho, Lee Chia An, Jeong Chang Yeong, Yang Hong Seuk
Department of Anesthesiology and Pain Medicine, Eulji University School of Medicine, Daejeon, Korea.
Anesth Pain Med (Seoul). 2022 Apr;17(2):191-198. doi: 10.17085/apm.21096. Epub 2022 Apr 5.
With increasing use, the incidence of adverse events associated with sugammadex, a neuromuscular blockade reverser, is increasing. This study aimed to identify and analyze cases of adverse events caused by sugammadex reported in Korean population.
Out of a total of 12 cases detected using various keywords in the Korean Journal of Anesthesia, Anesthesia and Pain Medicine (Seoul), KoreaMed, PubMed, EMBASE, Web of Science, and The Cochrane Library-CENTRAL from 2013 to December 2020, 10 cases directly associated with sugammadex were selected.
Adverse events included five cases of anaphylaxis, one case of cardiac arrest, one case of profound bradycardia, one case of negative pressure pulmonary edema, and two cases of incomplete recovery. Three patients had American Society of Anesthesiologists physical status ≥ 3, two had emergency surgery, and two had a history of allergic reaction. Neuromuscular monitoring was applied in nine cases. The average dose of sugammadex was 2.87 mg/kg, and there were six cases in which one full vial was used, regardless of the state of neuromuscular recovery. Sugammadex was administered immediately after surgery in two cases, at train of four (TOF) 0 in four cases, at TOF 3 in one case, and after evaluation of the clinical signs only with no neuromuscular monitoring in one case.
Even with neuromuscular monitoring, an excessive dose of sugammadex was observed. Given that adverse events tend to occur within 10 min of administration, continuous monitoring is important even after administration.
随着使用量的增加，神经肌肉阻滞逆转剂舒更葡糖钠相关不良事件的发生率正在上升。本研究旨在识别和分析韩国人群中报告的由舒更葡糖钠引起的不良事件病例。
在2013年至2020年12月期间，通过在《韩国麻醉学杂志》《麻醉与疼痛医学》（首尔）、韩国医学数据库、PubMed、EMBASE、科学网和考克兰图书馆 - 中央库中使用各种关键词检索到的总共12例病例中，选择了10例与舒更葡糖钠直接相关的病例。
不良事件包括5例过敏反应、1例心脏骤停、1例严重心动过缓、1例负压性肺水肿和2例恢复不完全。3例患者美国麻醉医师协会身体状况≥3级，2例进行急诊手术，2例有过敏反应史。9例应用了神经肌肉监测。舒更葡糖钠的平均剂量为2.87mg/kg，有6例无论神经肌肉恢复状态如何均使用了一整瓶。2例在术后立即给予舒更葡糖钠，4例在四个成串刺激（TOF）为0时给予，1例在TOF为3时给予，1例仅在评估临床体征后给予而未进行神经肌肉监测。
即使进行了神经肌肉监测，仍观察到舒更葡糖钠剂量过大。鉴于不良事件往往在给药后10分钟内发生，给药后持续监测很重要。
