{
    "abstract": "A 68-year-old man underwent elective surgical repair of an abdominal wall hernia under general anaesthesia. The operation required muscle relaxation, for which we used rocuronium. Following completion of surgery, 180\u2009mg sugammadex was administered intravenously. Shortly afterwards, the patient became severely bradycardic with hypotension, refractory to treatment with ephedrine. This progressed to a pulseless electrical activity cardiac arrest. After 4\u2009min of cardiopulmonary resuscitation, there was return of spontaneous circulation and, following a period of haemodynamic stability in which general anaesthesia was maintained, the patient emerged from anaesthesia without incident. He remained haemodynamically stable until discharge. Post-resuscitation investigations including the serum tryptase level were unremarkable except for a mild respiratory acidosis and slightly elevated D-dimers. Sugammadex-induced bradycardia has previously been described, but its mechanism remains unknown. We believe that sugammadex was the cause of cardiac arrest in this case because of the timing and sequence of events, the evolution to pulseless electric activity and the relatively uneventful post-arrest clinical course. We hope that our report will help to promote awareness about this potential complication of a now commonly-used drug.",
    "authors": [
        {
            "affiliation": "Department of Anesthesiology Hospital Vila Franca de Xira EPE Vila Franca de Xira Portugal.",
            "firstname": "A V",
            "initials": "AV",
            "lastname": "Pereira"
        },
        {
            "affiliation": "Department of Anesthesiology Hospital Vila Franca de Xira EPE Vila Franca de Xira Portugal.",
            "firstname": "R R",
            "initials": "RR",
            "lastname": "Oliveira"
        },
        {
            "affiliation": "Department of Anesthesiology Hospital Vila Franca de Xira EPE Vila Franca de Xira Portugal.",
            "firstname": "C",
            "initials": "C",
            "lastname": "Esteves"
        },
        {
            "affiliation": "Department of Anesthesiology Hospital Vila Franca de Xira EPE Vila Franca de Xira Portugal.",
            "firstname": "M A",
            "initials": "MA",
            "lastname": "Coutinho"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2023 Association of Anaesthetists.",
    "doi": "10.1002/anr3.12233",
    "journal": "Anaesthesia reports",
    "keywords": [
        "bradycardia",
        "cardiac arrest",
        "drug\u2010related side effects and adverse reactions",
        "patient safety",
        "sugammadex"
    ],
    "methods": null,
    "publication_date": "2023-06-05",
    "pubmed_id": "37273748\n29135598\n27703621\n36377554\n24848211\n19920893\n26966931\n29935599\n36017553\n28806470",
    "results": null,
    "title": "Cardiac arrest following sugammadex administration.",
    "xml": "<Element 'PubmedArticle' at 0x788506031cb0>"
}