Sugammadex in the Management of Sinus Tachycardia after Rocuronium Administration: A Case Report

Eduardo Fernandes Orioli Guimarães, Muriel Mofreita Saldanha, Tiago Coelho Fortes, Marcelo Grisolia, Marcos Lopes de Miranda, Carlos Darcy Alves Bersot

Department of Anesthesia, Lagoa Federal Hospital, Rio de Janeiro, Brazil.

DOI: 10.4236/ojanes.2014.49029                

Abstract

In rare cases, rocuronium has been associated with dose-related tachycardia, probably by a cardiac muscarinic M2 receptor blockade mechanism. We report the case of a 30-year-old female who underwent excision of a branchial cyst under general anesthesia. This patient presented an episode of sinus tachycardia (130 bpm) shortly after anesthesia induction with propofol, sufentanyl, and rocuronium. Tachycardia could not be explained by any cause other than the use of rocuronium, which was reverted with sugammadex. Two minutes after sugammadex administration, heart rate normalized, corroborating our hypothesis that rocuronium induced the sinus tachycardia observed in our patient. The patient recovered well from the anesthetic-surgical procedure and showed no further cardiovascular, ventilatory, or neurological changes, being transferred to the post-anesthesia care unit, and finally discharged to the ward.

Keywords

Rocuronium, Sugammadex, Anesthesia, Sinus Tachycardia

Conflicts of Interest

The authors declare no conflicts of interest.

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