• I-Chia Teng, Ying-Jen Chang, Yao-Tsung Lin, Chin-Chen Chu, Jen-Yin Chen, and Zhi-Fu Wu.
• Department of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan.
• Medicine (Baltimore). 2021 Jul 30; 100 (30): e26796e26796.

RationaleThere is evidence that sugammadex can facilitate extubation post-surgery and attenuate postoperative pulmonary complications resulting from postoperative residual neuromuscular blockade. However, it may induce adverse effects, including bronchospasm, laryngospasm, bradycardia, hypotension, and cardiac arrest. Here, we present a case of sugammadex-induced bradycardia and hypotension.Patient ConcernsAn 82-year-old female received video-assisted thoracic surgery decortication and wedge resection of the lung for empyema. Post-surgery, she developed bradycardia, hypotension, hypoxia, and weakness.DiagnosesThe patient was suspected to have sugammadex-induced bradycardia, hypotension, hypoxia and weakness.InterventionsThe patient received immediate treatment with atropine (0.5 mg) for bradycardia. Glycopyrrolate (0.1 mg) and neostigmine (1 mg) were administered to improve the train-of-four (TOF) ratio.OutcomesFollowing initial management, we observed improvement in the hemodynamics of the patient. She was discharged without any sequelae.LessonsSugammadex-induced bradycardia or cardiac arrest are rare; however, anesthesiologists must consider the possibility of the occurrence of such events and initiate appropriate management measures. Immediate treatment with atropine and inotropic or vasopressors is warranted if the patient presents with bradycardia.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

10 keywords...

hide…