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A Case Report of Acute Onset and Rapid Resolution of Atrioventricular Block After Sugammadex: Is the Autonomic System Involved? A A Pract 2023 May 01;17(5):e01683

Date

05/05/2023

Pubmed ID

37146215

DOI

10.1213/XAA.0000000000001683

Scopus ID

2-s2.0-85159329579 (requires institutional sign-in at Scopus site)

Abstract

Administering sugammadex to reverse neuromuscular blockade can cause marked bradycardia and rarely asystole. In this case, a rapid onset, biphasic heart rate response; slowing then speeding, after administering sugammadex was noted while at steady state, 1.3% end-tidal sevoflurane. On review of the electrocardiogram (ECG), the heart rate slowing coincided with the onset of a second-degree, Mobitz type I block that lasted 45 seconds. No other events, drugs, or stimuli coincided with the event. The acute onset and transient nature of the atrioventricular block without evidence of ischemia implies a brief parasympathetic effect on the atrioventricular node after sugammadex administration.

Author List

Abdelrahim MT, Kassels AC, Stark CW, Roberts CJ, Vogt JA, Ebert TJ

Author

Christopher J. Roberts MD, PhD Assistant Professor in the Anesthesiology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Atrioventricular Block
Bradycardia
Humans
Neuromuscular Nondepolarizing Agents
gamma-Cyclodextrins