Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 16, 2022; 10(35): 13138-13145
Published online Dec 16, 2022. doi: 10.12998/wjcc.v10.i35.13138
Unexpected delayed reversal of rocuronium-induced neuromuscular blockade by sugammadex: A case report and review of literature
Hao-Chen Wang, Cheng-Wei Lu, Tzu-Yu Lin, Ya-Ying Chang
Hao-Chen Wang, Cheng-Wei Lu, Tzu-Yu Lin, Ya-Ying Chang, Department of Anesthesiology, Far-Eastern Memorial Hospital, New Taipei City 220, Taiwan
Cheng-Wei Lu, Tzu-Yu Lin, Department of Mechanical Engineering, Yuan Ze University, Chung-Li 320, Taiwan
Ya-Ying Chang, International Program in Engineering for Bachelor, Yuan Ze University, Chung-Li 320, Taiwan
Author contributions: Wang HC and Lu CW contributed to manuscript writing and editing, and data collection; Wang HC and Lin TY performed the general anesthesia; Chang YY contributed to conceptualization and supervision; All authors have read and approved the final manuscript.
Supported by Far-Eastern Memorial Hospital, No. FEMH-2022-C-057.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ya-Ying Chang, PhD, Professor, Department of Anesthesiology, Far-Eastern Memorial Hospital, No. 21 Sec. 2 Nanya S. Road, Banqiao District, New Taipei City 220, Taiwan. gingerdoll@gmail.com
Received: November 3, 2022
Peer-review started: November 3, 2022
First decision: November 14, 2022
Revised: November 16, 2022
Accepted: November 18, 2022
Article in press: November 18, 2022
Published online: December 16, 2022
Core Tip

Core Tip: Sugammadex reverses rocuronium-induced neuromuscular blocking effect, providing full and rapid recovery from general anesthesia. However, in rare cases, patients with neuromuscular diseases may response poorly to sugammadex. In our patient, suspected neuromuscular disease, renal insufficiency, and a history of delayed recovery from general anesthesia may indicate a delayed recovery course. An optimal dose of rocuronium adjusted by train-of-four neuromuscular monitoring throughout the surgery helps reduce the risk of prolonged recovery from general anesthesia.