The role of sugammadex in a patient with respiratory failure followed by postoperative anaphylactoid reaction [Postoperatif anaflaktoid reaksiyon sonrasi gelişen solunum yetmezüǧi olgusunda sugammadeksin rolü]

In this case report; reversal of anaphylactoid reaction-related postoperative residual neuromuscular paralysis and oxygen desaturation with sugammadeks has been presented in a 64- year- old woman with recurrence endometrial cancer undergoing abdominal laparotomy and staging surgery. patient was extubated and transferred to the recovery unit following the end of surgery. on arrival recovery unit,erythema and urticaria was observed,firstly,in head-neck region and then in the whole body,followed by angioedema. in respiratory variables,oxygen desaturation was observed and oxygen saturation was dropped quickly first to 89 % and then 79 % and continued to drop down. on developing asphyxia,shortness of breath,cough,laryngospasm,hypoxemia and cyanosis,to increase oxygenation,positive pressure ventilation was launched. patient was administered rapid fluid infusion,im 0.3 mg adrenaline,iv 4 mg kg' metilprednisolone and 40 mg antistine. urticarial and hemodynamic symptoms were resolved quickly,however respiratory functions were partially improved and oxygen saturation values remained lower than safety values (〈90%).it was supposed that postoperative residual neuromuscular paralysis,which causes impossible to reach safe oxygenation levels,was worsened by anaphylactoid reaction and 2 mg kg' of sugammadex was administered intravenously. within 3-4 minutes,respiration was better and oxygen saturation values reached to safer levels and she did not need the positive pressure ventilation support.it is important to keep in mind that beside antiallergic and antiedema therapy,the use of sugammadex significantly improves respiratory functions in a woman that developed postoperative anaphylactoid reaction leading to résiduel neuromuscular paralysis and oxygen desaturation.