Reversal of prolonged rocuronium neuromuscular blockade with sugammadex in an obstetric patient with transverse myelitis.

Hdl Handle:
http://hdl.handle.net/10147/189943
Title:
Reversal of prolonged rocuronium neuromuscular blockade with sugammadex in an obstetric patient with transverse myelitis.
Authors:
Weekes, G; Hayes, N; Bowen, M
Affiliation:
Department of Anaesthesiology, Rotunda Hospital, Dublin, Ireland. gavin.weekes@gmail.com
Citation:
Reversal of prolonged rocuronium neuromuscular blockade with sugammadex in an obstetric patient with transverse myelitis. 2010, 19 (3):333-6 Int J Obstet Anesth
Journal:
International journal of obstetric anesthesia
Issue Date:
Jul-2010
URI:
http://hdl.handle.net/10147/189943
DOI:
10.1016/j.ijoa.2010.03.009
PubMed ID:
20627694
Additional Links:
http://www.sciencedirect.com/science/article/pii/S0959289X1000035X
Abstract:
A 38-year-old wheelchair-bound primigravida with transverse myelitis presented at 38 weeks of gestation for elective caesarean section. Transverse myelitis, which is characterised by bilateral inflammation of the spinal cord and myelin destruction, is associated with myopathy, autonomic dysreflexia and pulmonary aspiration. Regional anaesthesia was contraindicated in this case as the patient had undergone two previous lumbar spinal fusion procedures. Rocuronium 1.2 mg/kg was used to facilitate rapid intubating conditions. The caesarean section proceeded uneventfully, but even after administration of neostigmine the patient exhibited prolonged neuromuscular blockade. After 3 h and 15 min sugammadex was obtained to reverse neuromuscular blockade; the drug was not stocked in our hospital. Sugammadex 4 mg/kg resulted in complete reversal of blockade after 2 min. We believe that myopathy associated with transverse myelitis led to the prolonged duration of action of rocuronium. Sugammadex is a relatively new drug with few reported side effects. In this case it was used to reverse neuromuscular blockade and prevented prolonged postoperative ventilatory support.
Item Type:
Article
Language:
en
Description:
A 38-year-old wheelchair-bound primigravida with transverse myelitis presented at 38 weeks of gestation for elective caesarean section. Transverse myelitis, which is characterised by bilateral inflammation of the spinal cord and myelin destruction, is associated with myopathy, autonomic dysreflexia and pulmonary aspiration. Regional anaesthesia was contraindicated in this case as the patient had undergone two previous lumbar spinal fusion procedures. Rocuronium 1.2 mg/kg was used to facilitate rapid intubating conditions. The caesarean section proceeded uneventfully, but even after administration of neostigmine the patient exhibited prolonged neuromuscular blockade. After 3 h and 15 min sugammadex was obtained to reverse neuromuscular blockade; the drug was not stocked in our hospital. Sugammadex 4 mg/kg resulted in complete reversal of blockade after 2 min. We believe that myopathy associated with transverse myelitis led to the prolonged duration of action of rocuronium. Sugammadex is a relatively new drug with few reported side effects. In this case it was used to reverse neuromuscular blockade and prevented prolonged postoperative ventilatory support.
MeSH:
Adult; Androstanols; Anesthesia, General; Anesthesia, Obstetrical; Cesarean Section; Female; Humans; Infant, Newborn; Male; Myelitis, Transverse; Neuromuscular Blockade; Neuromuscular Nondepolarizing Agents; Paralysis; Pregnancy; Pregnancy Complications; gamma-Cyclodextrins
ISSN:
1532-3374

Full metadata record

DC FieldValue Language
dc.contributor.authorWeekes, Gen
dc.contributor.authorHayes, Nen
dc.contributor.authorBowen, Men
dc.date.accessioned2011-11-18T14:42:13Z-
dc.date.available2011-11-18T14:42:13Z-
dc.date.issued2010-07-
dc.identifier.citationReversal of prolonged rocuronium neuromuscular blockade with sugammadex in an obstetric patient with transverse myelitis. 2010, 19 (3):333-6 Int J Obstet Anesthen
dc.identifier.issn1532-3374-
dc.identifier.pmid20627694-
dc.identifier.doi10.1016/j.ijoa.2010.03.009-
dc.identifier.urihttp://hdl.handle.net/10147/189943-
dc.descriptionA 38-year-old wheelchair-bound primigravida with transverse myelitis presented at 38 weeks of gestation for elective caesarean section. Transverse myelitis, which is characterised by bilateral inflammation of the spinal cord and myelin destruction, is associated with myopathy, autonomic dysreflexia and pulmonary aspiration. Regional anaesthesia was contraindicated in this case as the patient had undergone two previous lumbar spinal fusion procedures. Rocuronium 1.2 mg/kg was used to facilitate rapid intubating conditions. The caesarean section proceeded uneventfully, but even after administration of neostigmine the patient exhibited prolonged neuromuscular blockade. After 3 h and 15 min sugammadex was obtained to reverse neuromuscular blockade; the drug was not stocked in our hospital. Sugammadex 4 mg/kg resulted in complete reversal of blockade after 2 min. We believe that myopathy associated with transverse myelitis led to the prolonged duration of action of rocuronium. Sugammadex is a relatively new drug with few reported side effects. In this case it was used to reverse neuromuscular blockade and prevented prolonged postoperative ventilatory support.en
dc.description.abstractA 38-year-old wheelchair-bound primigravida with transverse myelitis presented at 38 weeks of gestation for elective caesarean section. Transverse myelitis, which is characterised by bilateral inflammation of the spinal cord and myelin destruction, is associated with myopathy, autonomic dysreflexia and pulmonary aspiration. Regional anaesthesia was contraindicated in this case as the patient had undergone two previous lumbar spinal fusion procedures. Rocuronium 1.2 mg/kg was used to facilitate rapid intubating conditions. The caesarean section proceeded uneventfully, but even after administration of neostigmine the patient exhibited prolonged neuromuscular blockade. After 3 h and 15 min sugammadex was obtained to reverse neuromuscular blockade; the drug was not stocked in our hospital. Sugammadex 4 mg/kg resulted in complete reversal of blockade after 2 min. We believe that myopathy associated with transverse myelitis led to the prolonged duration of action of rocuronium. Sugammadex is a relatively new drug with few reported side effects. In this case it was used to reverse neuromuscular blockade and prevented prolonged postoperative ventilatory support.-
dc.language.isoenen
dc.relation.urlhttp://www.sciencedirect.com/science/article/pii/S0959289X1000035Xen
dc.subject.meshAdult-
dc.subject.meshAndrostanols-
dc.subject.meshAnesthesia, General-
dc.subject.meshAnesthesia, Obstetrical-
dc.subject.meshCesarean Section-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshInfant, Newborn-
dc.subject.meshMale-
dc.subject.meshMyelitis, Transverse-
dc.subject.meshNeuromuscular Blockade-
dc.subject.meshNeuromuscular Nondepolarizing Agents-
dc.subject.meshParalysis-
dc.subject.meshPregnancy-
dc.subject.meshPregnancy Complications-
dc.subject.meshgamma-Cyclodextrins-
dc.titleReversal of prolonged rocuronium neuromuscular blockade with sugammadex in an obstetric patient with transverse myelitis.en
dc.typeArticleen
dc.contributor.departmentDepartment of Anaesthesiology, Rotunda Hospital, Dublin, Ireland. gavin.weekes@gmail.comen
dc.identifier.journalInternational journal of obstetric anesthesiaen
dc.description.provinceLeinster-

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