• J Pediatr Pharmacol Ther · Sep 2017

    Case Reports

    Bradycardia in a Pediatric Heart Transplant Recipient: Is It the Sugammadex?

    • Adele King, Aymen Naguib, and Joseph D Tobias.
    • Department of Anesthesiology & Pain Medicine (AK, AN, JDT), Nationwide Children's Hospital, Columbus, Ohio, Department of Anesthesiology & Pain Medicine (AN, JDT), The Ohio State University College of Medicine, Columbus, Ohio, and Department of Pediatrics (JDT), The Ohio State University College of Medicine, Columbus, Ohio.
    • J Pediatr Pharmacol Ther. 2017 Sep 1; 22 (5): 378-381.

    AbstractSugammadex is a novel pharmacologic agent that is used to selectively reverse the effects of the neuromuscular blocking agents rocuronium and vecuronium. Various advantages have been reported when comparing its reversal of neuromuscular blockade to that achieved with acetylcholinesterase inhibitors (neostigmine). In heart transplant recipients, bradycardia may occur following the administration of acetylcholinesterase inhibitors, due to the denervation of the heart. Theoretically, the combination of rocuronium and sugammadex could be advantageous in this clinical scenario to avoid the potential bradycardia resulting from neostigmine administration. We present a 10-year-old male who developed profound bradycardia immediately following the administration of intravenous sugammadex. The options for reversal of neuromuscular blockade in heart transplant recipients is discussed, previous reports of bradycardia following sugammadex are presented, and the role of sugammadex in the bradycardia in our patient is reviewed.

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