Department of Cardiology, Jeju National University Hospital, Jeju, Korea.
Department of Anesthesiology and Pain Medicine, Jeju National University College of Medicine, Jeju, Korea.
Korean J Anesthesiol. 2023 Feb;76(1):72-76. doi: 10.4097/kja.22335. Epub 2022 Aug 18.
Sugammadex is a widely used medication for the reversal of aminosteroid neuromuscular blockades. Although sugammadex is generally regarded to be safe, concerns about the risk of serious complications have emerged.
A 57-year-old man without a history of coronary disease was scheduled for general anesthesia to undergo cardiac radiofrequency catheter ablation due to symptomatic persistent atrial fibrillation and flutter. At the end of the procedure, he was given 400 mg of sugammadex. A little later, the electrocardiogram showed a sudden ST elevation on the inferior leads, followed by cardiac arrest. The urgent coronary angiography demonstrated total collapse of the right coronary artery. After two injections of intra-coronary nitroglycerin, the vasospasm of the right coronary artery was completely resolved. The patient recovered without sequelae and was discharged on postoperative day 5.
Clinicians should pay close attention to the potential risk of coronary vasospasm, even cardiac arrest, after sugammadex administration.
Sugammadex 是一种广泛用于逆转氨基甾体类神经肌肉阻滞的药物。尽管 Sugammadex 通常被认为是安全的，但人们对其严重并发症风险的担忧已经出现。
一名 57 岁男性，无冠心病病史，因持续性有症状的心房颤动和扑动而接受全身麻醉进行心脏射频导管消融术。手术结束时，给予患者 400 毫克的 Sugammadex。不久后，心电图显示下导联出现突然的 ST 段抬高，随后出现心脏骤停。紧急冠状动脉造影显示右冠状动脉完全闭塞。冠状动脉内给予两次硝酸甘油注射后，右冠状动脉痉挛完全缓解。患者无后遗症恢复，并于术后第 5 天出院。
临床医生应密切关注 Sugammadex 给药后发生冠状动脉痉挛甚至心脏骤停的潜在风险。
