2023 FSA Podium and Poster Abstracts

P053: CASE REPORT: INTRAOPERATIVE ANAPHYLAXIS TO SUGAMMADEX
Giedre Laurinaitis, MD; Gisele Wakim, MD; University of Miami/Jackson Memorial

Introduction: Recent guidelines from the 2023 American Society of Anesthesiologists task force for management of neuromuscular blockade favor sugammadex use for routine use of reversal of neuromuscular blockade.

Methods/Results: We report a case of sugammadex-induced anaphylaxis during general anesthesia in a 59-year-old female undergoing hysteroscopy/polypectomy presenting as profound hypotension and rash on torso. The timing of onset was 3 minutes following sugammadex administration. The patient recovered after extensive therapy including fluids and epinephrine. Tryptase level were drawn 15 minutes after the episode and were found to be markedly elevated once they resulted 5 days after.

Conclusions: This is a rare case of sugammadex induced anaphylaxis with elevated tryptase level, supporting a reaction to sugammadex. It reinforces the possibility of anaphylactic reactions to this widely used medication and makes clinicians aware of the importance of epinephrine use for treatment.