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Sugammadex Reversal of a Large Subcutaneous Depot of Rocuronium in a Dialysis Patient

A Case Report

Navare, Sagar R., MD; Garcia Medina, Oscar, MD; Prielipp, Richard C., MD, MBA, FCCM; Weinkauf, Julia L., MD

doi: 10.1213/XAA.0000000000000934
Case Reports

Sugammadex is a modified gamma cyclodextrin that encapsulates rocuronium. We report the successful use of sugammadex in the management of an elderly man with end-stage renal failure who sustained an infiltration of subcutaneous rocuronium during rapid sequence induction of general anesthesia. Given the erratic absorption of subcutaneous rocuronium from the tissue, sugammadex was chosen to reverse the neuromuscular block at the end of the procedure. This report demonstrates the efficacy of sugammadex to reverse neuromuscular block in elderly patients with poor renal function. Moreover, the duration of action for sugammadex was sufficient to neutralize the ongoing absorption of subcutaneous rocuronium.

From the Department of Anesthesiology, University of Minnesota, Minneapolis, Minnesota.

Accepted for publication October 29, 2018.

Conflicts of Interest: See Disclosures at the end of the article.

Funding: None.

Address correspondence to Julia L. Weinkauf, MD, Department of Anesthesiology, University of Minnesota, 444 Laurel Ave, St Paul, MN 55102. Address e-mail to

© 2019 International Anesthesia Research Society
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