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Case Reports
. 2023 Feb;76(1):72-76.
doi: 10.4097/kja.22335. Epub 2022 Aug 18.

Cardiac arrest due to coronary vasospasm after sugammadex administration -a case report

Ki Yung Boo  1 , Sang Hyun Park  2 , Sun Kyung Park  2 , Changrock Na  3 , Hyun Jung Kim  2
Affiliations
Case Reports

Cardiac arrest due to coronary vasospasm after sugammadex administration -a case report

Ki Yung Boo et al. Korean J Anesthesiol. 2023 Feb.

Abstract

Background: Sugammadex is a widely used medication for the reversal of aminosteroid neuromuscular blockades. Although sugammadex is generally regarded to be safe, concerns about the risk of serious complications have emerged.

Case: A 57-year-old man without a history of coronary disease was scheduled for general anesthesia to undergo cardiac radiofrequency catheter ablation due to symptomatic persistent atrial fibrillation and flutter. At the end of the procedure, he was given 400 mg of sugammadex. A little later, the electrocardiogram showed a sudden ST elevation on the inferior leads, followed by cardiac arrest. The urgent coronary angiography demonstrated total collapse of the right coronary artery. After two injections of intra-coronary nitroglycerin, the vasospasm of the right coronary artery was completely resolved. The patient recovered without sequelae and was discharged on postoperative day 5.

Conclusions: Clinicians should pay close attention to the potential risk of coronary vasospasm, even cardiac arrest, after sugammadex administration.

Keywords: Anesthesia; Cardiopulmonary resuscitation; Coronary angiography; Coronary vasospasm; Heart arrest; Sugammadex.

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Conflict of interest statement

Conflicts of Interest

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
Electrocardiogram (ECG). (A) At the end of radiofrequency catheter ablation, the ECG showed normal. (B) After sugammadex administration, it suddenly demonstrated ST elevation on the inferior leads.
Fig. 2.
Fig. 2.
Left anterior oblique view on coronary angiography. (A) After cardiac arrest, the right coronary artery totally collapsed. (B) After the first injection of intra-coronary nitroglycerin, the right coronary artery was partially dilated. (C) After an additional injection of intra-coronary nitroglycerin, the vasospasm of the right coronary artery was completely resolved. Black arrow: right coronary artery.
See this image and copyright information in PMC

References

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