Reversal of Vecuronium-induced Neuromuscular Blockade with Sugammadex in a Child with Moebius Syndrome after Accidental Extubation
Catia Real, Joana Guimaraes, Rita Frada, Maria Joao Freitas, Pedro Pina and Humberto Machado*
Serviço de Anestesiologia, Centro Hospitalar do Porto, Largo Abel Salazar, 4099-001 Porto, Portugal
- *Corresponding Author:
- Humberto Machado
Serviço de Anestesiologia, Centro Hospitalar do Porto
Largo Abel Salazar, 4099-001 Porto, Portugal
E-mail: [email protected]
Received date: August 11, 2015 Accepted date: September 25, 2015 Published date: September 29, 2015
Citation: Real C, Guimaraes J, Frada R, Freitas MJ, Pina P, et al. (2015) Reversal of Vecuronium-induced Neuromuscular Blockade with Sugammadex in a Child with Moebius Syndrome after Accidental Extubation. J Anesth Clin Res 6:571. doi: 10.4172/2155-6148.1000571
Copyright: © 2015 Real C et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Sugammadex chemically encapsulates rocuronium and vecuronium, thereby rapidly terminating the neuromuscular blockade induced by these agents. Although the experience with the use of sugammadex in children under 2 years of age is limited, it may be considered in specific clinical contexts.
We present a case where spontaneous efficient respiratory effort was resumed after reversal of vecuroniuminduced neuromuscular blockade with sugammadex in a child. A 21-month-old boy with a history of Moebius syndrome and obstructive sleep apnea needing night time noninvasive ventilation support was scheduled for adenotonsillectomy and bilateral myringotomy. Tracheal intubation was anticipated to be difficult and so it was performed using a videolaryngoscope. In the postoperative period the child remained intubated in the intensive care unit sedated and with a continuous infusion of vecuronium. On day 3 accidental extubation occurred. As it was considered an urgent situation, flumazenil, naloxone and sugammadex 2 mg.kg-1 were administered with rapid return of spontaneous respiration and consciousness, obviating the need of unnecessary airway manipulation and the inherent risks.