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Efficacy of sugammadex in rocuronium‐induced or antibiotic‐induced anaphylaxis. A case–control study
Summary We report 13 cases of presumed rocuronium‐induced anaphylaxis in which sugammadex was administered with the intention of reversing the immunological reaction. Of these 13 cases, eight (62%) were later confirmed to be type‐1 hypersensitivity reactions to rocuronium, three (23%) were triggered...
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Published in: | Anaesthesia 2015-11, Vol.70 (11), p.1264-1267 |
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creator | Platt, P. R. Clarke, R. C. Johnson, G. H. Sadleir, P. H. M. |
description | Summary
We report 13 cases of presumed rocuronium‐induced anaphylaxis in which sugammadex was administered with the intention of reversing the immunological reaction. Of these 13 cases, eight (62%) were later confirmed to be type‐1 hypersensitivity reactions to rocuronium, three (23%) were triggered by an antibiotic and two (15%) were non‐immunologically mediated. Response to treatment was scored by the treating anaesthetist, and compared with haemodynamic and inotrope measurements from the resuscitation and anaesthetic records. Haemodynamic improvement was seen in only six (46%) cases, three of which were associated with a non‐rocuronium trigger. Of the three cases in which the treating anaesthetist thought that sugammadex had been beneficial, one was not caused by rocuronium, one had no improvement in blood pressure and one required 8.5 times as much adrenaline in boluses after, compared with the period before, sugammadex administration. These data suggest that sugammadex does not modify the clinical course of a suspected hypersensitivity reaction. |
doi_str_mv | 10.1111/anae.13178 |
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We report 13 cases of presumed rocuronium‐induced anaphylaxis in which sugammadex was administered with the intention of reversing the immunological reaction. Of these 13 cases, eight (62%) were later confirmed to be type‐1 hypersensitivity reactions to rocuronium, three (23%) were triggered by an antibiotic and two (15%) were non‐immunologically mediated. Response to treatment was scored by the treating anaesthetist, and compared with haemodynamic and inotrope measurements from the resuscitation and anaesthetic records. Haemodynamic improvement was seen in only six (46%) cases, three of which were associated with a non‐rocuronium trigger. Of the three cases in which the treating anaesthetist thought that sugammadex had been beneficial, one was not caused by rocuronium, one had no improvement in blood pressure and one required 8.5 times as much adrenaline in boluses after, compared with the period before, sugammadex administration. These data suggest that sugammadex does not modify the clinical course of a suspected hypersensitivity reaction.</description><identifier>ISSN: 0003-2409</identifier><identifier>EISSN: 1365-2044</identifier><identifier>DOI: 10.1111/anae.13178</identifier><identifier>PMID: 26259130</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Allergies ; Anaphylaxis - chemically induced ; Anaphylaxis - drug therapy ; Androstanols - adverse effects ; Anesthesia ; Anti-Bacterial Agents - adverse effects ; Antibiotics ; Case-Control Studies ; gamma-Cyclodextrins - pharmacology ; Hemodynamics - drug effects ; Humans ; Neuromuscular Nondepolarizing Agents - adverse effects ; Retrospective Studies ; Treatment Outcome</subject><ispartof>Anaesthesia, 2015-11, Vol.70 (11), p.1264-1267</ispartof><rights>2015 The Association of Anaesthetists of Great Britain and Ireland</rights><rights>2015 The Association of Anaesthetists of Great Britain and Ireland.</rights><rights>Copyright © 2015 The Association of Anaesthetists of Great Britain and Ireland</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4638-f112287f71531141b5882c2ec12bde55031dfdb7e6261c2f7c93f37af88e36653</citedby><cites>FETCH-LOGICAL-c4638-f112287f71531141b5882c2ec12bde55031dfdb7e6261c2f7c93f37af88e36653</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26259130$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Platt, P. R.</creatorcontrib><creatorcontrib>Clarke, R. C.</creatorcontrib><creatorcontrib>Johnson, G. H.</creatorcontrib><creatorcontrib>Sadleir, P. H. M.</creatorcontrib><title>Efficacy of sugammadex in rocuronium‐induced or antibiotic‐induced anaphylaxis. A case–control study</title><title>Anaesthesia</title><addtitle>Anaesthesia</addtitle><description>Summary
We report 13 cases of presumed rocuronium‐induced anaphylaxis in which sugammadex was administered with the intention of reversing the immunological reaction. Of these 13 cases, eight (62%) were later confirmed to be type‐1 hypersensitivity reactions to rocuronium, three (23%) were triggered by an antibiotic and two (15%) were non‐immunologically mediated. Response to treatment was scored by the treating anaesthetist, and compared with haemodynamic and inotrope measurements from the resuscitation and anaesthetic records. Haemodynamic improvement was seen in only six (46%) cases, three of which were associated with a non‐rocuronium trigger. Of the three cases in which the treating anaesthetist thought that sugammadex had been beneficial, one was not caused by rocuronium, one had no improvement in blood pressure and one required 8.5 times as much adrenaline in boluses after, compared with the period before, sugammadex administration. These data suggest that sugammadex does not modify the clinical course of a suspected hypersensitivity reaction.</description><subject>Allergies</subject><subject>Anaphylaxis - chemically induced</subject><subject>Anaphylaxis - drug therapy</subject><subject>Androstanols - adverse effects</subject><subject>Anesthesia</subject><subject>Anti-Bacterial Agents - adverse effects</subject><subject>Antibiotics</subject><subject>Case-Control Studies</subject><subject>gamma-Cyclodextrins - pharmacology</subject><subject>Hemodynamics - drug effects</subject><subject>Humans</subject><subject>Neuromuscular Nondepolarizing Agents - adverse effects</subject><subject>Retrospective Studies</subject><subject>Treatment Outcome</subject><issn>0003-2409</issn><issn>1365-2044</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><recordid>eNp90ctKAzEYBeAgiq3VjQ8gATciTM2fzCVdllIvILrR9ZDJJJoyM6nJBDs7H0HwDX0Sp1ZFXJhNIHwcDjkIHQIZQ3_ORCPUGBhkfAsNgaVJREkcb6MhIYRFNCaTAdrzfkEIUA58Fw1oSpMJMDJEi7nWRgrZYauxDw-irkWpVtg02FkZnG1MqN9fXk1TBqlKbB0WTWsKY1sjf733HZaPXSVWxo_xFEvh1fvLm7RN62yFfRvKbh_taFF5dfB1j9D9-fxudhld315czabXkYxTxiMNQCnPdAYJA4ihSDinkioJtChVkhAGpS6LTKU0BUl1JidMs0xozhVL04SN0Mkmd-nsU1C-zWvjpaoq0SgbfA4ZBZawFEhPj__QhQ2u6dutFWGE9pV6dbpR0lnvndL50plauC4Hkq8XyNcL5J8L9PjoKzIUtSp_6PeX9wA24NlUqvsnKp_eTOeb0A-IgZMv</recordid><startdate>201511</startdate><enddate>201511</enddate><creator>Platt, P. R.</creator><creator>Clarke, R. C.</creator><creator>Johnson, G. H.</creator><creator>Sadleir, P. H. M.</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U7</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201511</creationdate><title>Efficacy of sugammadex in rocuronium‐induced or antibiotic‐induced anaphylaxis. A case–control study</title><author>Platt, P. R. ; Clarke, R. C. ; Johnson, G. H. ; Sadleir, P. H. M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4638-f112287f71531141b5882c2ec12bde55031dfdb7e6261c2f7c93f37af88e36653</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Allergies</topic><topic>Anaphylaxis - chemically induced</topic><topic>Anaphylaxis - drug therapy</topic><topic>Androstanols - adverse effects</topic><topic>Anesthesia</topic><topic>Anti-Bacterial Agents - adverse effects</topic><topic>Antibiotics</topic><topic>Case-Control Studies</topic><topic>gamma-Cyclodextrins - pharmacology</topic><topic>Hemodynamics - drug effects</topic><topic>Humans</topic><topic>Neuromuscular Nondepolarizing Agents - adverse effects</topic><topic>Retrospective Studies</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Platt, P. R.</creatorcontrib><creatorcontrib>Clarke, R. C.</creatorcontrib><creatorcontrib>Johnson, G. H.</creatorcontrib><creatorcontrib>Sadleir, P. H. M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Anaesthesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Platt, P. R.</au><au>Clarke, R. C.</au><au>Johnson, G. H.</au><au>Sadleir, P. H. M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy of sugammadex in rocuronium‐induced or antibiotic‐induced anaphylaxis. A case–control study</atitle><jtitle>Anaesthesia</jtitle><addtitle>Anaesthesia</addtitle><date>2015-11</date><risdate>2015</risdate><volume>70</volume><issue>11</issue><spage>1264</spage><epage>1267</epage><pages>1264-1267</pages><issn>0003-2409</issn><eissn>1365-2044</eissn><abstract>Summary
We report 13 cases of presumed rocuronium‐induced anaphylaxis in which sugammadex was administered with the intention of reversing the immunological reaction. Of these 13 cases, eight (62%) were later confirmed to be type‐1 hypersensitivity reactions to rocuronium, three (23%) were triggered by an antibiotic and two (15%) were non‐immunologically mediated. Response to treatment was scored by the treating anaesthetist, and compared with haemodynamic and inotrope measurements from the resuscitation and anaesthetic records. Haemodynamic improvement was seen in only six (46%) cases, three of which were associated with a non‐rocuronium trigger. Of the three cases in which the treating anaesthetist thought that sugammadex had been beneficial, one was not caused by rocuronium, one had no improvement in blood pressure and one required 8.5 times as much adrenaline in boluses after, compared with the period before, sugammadex administration. These data suggest that sugammadex does not modify the clinical course of a suspected hypersensitivity reaction.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>26259130</pmid><doi>10.1111/anae.13178</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Allergies Anaphylaxis - chemically induced Anaphylaxis - drug therapy Androstanols - adverse effects Anesthesia Anti-Bacterial Agents - adverse effects Antibiotics Case-Control Studies gamma-Cyclodextrins - pharmacology Hemodynamics - drug effects Humans Neuromuscular Nondepolarizing Agents - adverse effects Retrospective Studies Treatment Outcome |
title | Efficacy of sugammadex in rocuronium‐induced or antibiotic‐induced anaphylaxis. A case–control study |
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