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Sugammadex: Efficacy and Practicality in the Dental Office
Stephen GoetzDMD,
Benjamin PrittsDMD, and
Bryant Cornelius. DDSMBA, MPH
Article Category: Research Article
Volume/Issue: Volume 65: Issue 2
Online Publication Date: Jan 01, 2018
DOI: 10.2344/anpr-65-03-03
Page Range: 113 – 118

ensure the safest and most responsible care possible. 2 Office-based anesthesia providers must be aware of the latest developments in hospital-based anesthesia and determine if new drugs and modalities offer improvements to the uniquely challenging aspects of office-based dental anesthesia. Sugammadex, a new drug gaining popularity in hospital anesthesia, has great potential to influence the way office-based dental anesthesia is practiced. ABOUT SUGAMMADEX In December 2015, the US Food and Drug Administration (FDA) approved sugammadex

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Suspected Sinus Arrest After Sugammadex Administration: A Case Report
Takuya UchidaDDS, PhD,
Tamao IkunoDDS,
Yoshinori IkedaDDS,
Mie UedaDDS,
Akina ToyaDDS,
Yozo ManabeDDS, PhD, and
Yoshihiro MomotaDDS, PhD
Article Category: Brief Report
Volume/Issue: Volume 71: Issue 4
Online Publication Date: Dec 04, 2024
DOI: 10.2344/anpr-23-0054
Page Range: 194 – 196

Electrocardiographic abnormalities associated with the administration of sugammadex have been reported and include bradycardia, tachycardia, QT prolongation, severe atrioventricular block, ventricular fibrillation, ventricular tachycardia, and cardiac arrest. We report the case of a male patient undergoing intubated general anesthesia for dental treatment who experienced acute onset bradyarrhythmia following administration of sugammadex to reverse rocuronium-induced neuromuscular paralysis. CASE PRESENTATION The patient was a 21-year-old man (height, 162

Two Cases of Rocuronium-Induced Anaphylaxis/Anaphylactic Shock Successfully Treated With Sugammadex
Mayumi HashimotoDDS,
Aiji Sato (Boku)DDS, PhD,
Naoko TachiDDS, PhD,
Yoko OkumuraDDS,
Kanenori KadoiDDS,
Jun HaradaMD, PhD, and
Masahiro OkudaMD, PhD
Article Category: Case Report
Volume/Issue: Volume 66: Issue 3
Online Publication Date: Jan 01, 2019
DOI: 10.2344/anpr-66-01-07
Page Range: 151 – 155

estimated that there is 1 case for every 6,500 administrations. 2 Rocuronium is thought to have the highest frequency of allergic reactions. 3 We report 2 cases of anaphylaxis/anaphylactic shock believed to be induced by rocuronium, in which anaphylactic symptoms disappeared following administration of sugammadex and for which remission was achieved without further complications. In preparing this report, written consent for this publication was obtained from the patient herself (case 1) and from the patient and her parents (case 2

Use of Rocuronium and Sugammadex for a Patient With Controlled Polymyositis: A Case Report
Hidetaka KurodaDDS, PhD,
Tomomi KatayamaDDS,
Atsuki YamaguchiDDS,
Norika KatagiriDDS, PhD,
Shota TsukimotoDDS, PhD,
Uno ImaizumiDDS, PhD, and
Takuro SanukiDDS, PhD
Article Category: Case Report
Volume/Issue: Volume 71: Issue 2
Online Publication Date: Jul 08, 2024
DOI: 10.2344/021627
Page Range: 81 – 84

patient’s NMB data are presented in the ( Table ). No additional rocuronium was administered during surgery. Sevoflurane was started at 2% after tracheal intubation, changed to 1.5% at 15 minutes before the end of surgery, and discontinued at the end of surgery. Although 2 hours had elapsed since rocuronium was administered during induction, the TOF ratio was 49%. Table. Changes in Muscle Relaxation State During General Anesthesia a At the end of surgery (ie, 120 minutes after administration of rocuronium), IV sugammadex (200 mg) was administered to

Figure 2.  ; Molecular structure of sugammadex.
Michelle Wong
<bold>Figure 2. </bold>
Figure 2. 

Molecular structure of sugammadex.

Figure.; ECG (Lead II) Before and After Sugammadex Administration Profound bradyarrhythmias noted immediately after IV administration of 200 mg of sugammadex.
Takuya Uchida,
Tamao Ikuno,
Yoshinori Ikeda,
Mie Ueda,
Akina Toya,
Yozo Manabe, and
Yoshihiro Momota
Figure.
Figure.

ECG (Lead II) Before and After Sugammadex Administration

Profound bradyarrhythmias noted immediately after IV administration of 200 mg of sugammadex.

Reversal Agents in Sedation and Anesthesia Practice for Dentistry
Michelle WongDDS, MSc, EdD
Article Category: Research Article
Volume/Issue: Volume 69: Issue 1
Online Publication Date: Apr 04, 2022
DOI: 10.2344/anpr-69-01-09
Page Range: 49 – 58

Knowledge of reversal agents, or pharmacologic antagonists, is essential for all providers of sedation and general anesthesia. Reversal agents are defined as any drug used to counter the pharmacologic effects of another drug. 1 This article reviews common reversal agents used in contemporary sedation and anesthesia practice for dentistry, specifically flumazenil, naloxone, neostigmine, sugammadex, and phentolamine, and discusses their use in emergency management and routine practice. This article also reviews safety considerations and

Figure 2.; Second Episode of Erythema After Administration of Sugammadex The second episode of erythema, which involved the patient’s neck and chest, developed after administration of sugammadex with the erythema being more pronounced on the right side of the chest. This photograph was taken approximately 15 minutes after the erythema appeared and after extubation.
Misato Kobashi,
Hiroyo Yoshimoto,
Hanako Ohke,
Kenji Goh,
Naomasa Fujita,
Kaho Mizuno,
Kaisei Saitoh,
Satomi Ando,
Masato Saitoh, and
Makoto Terumitsu
Figure 2.
Figure 2.

Second Episode of Erythema After Administration of Sugammadex

The second episode of erythema, which involved the patient’s neck and chest, developed after administration of sugammadex with the erythema being more pronounced on the right side of the chest. This photograph was taken approximately 15 minutes after the erythema appeared and after extubation.

Figure 1.  ; Schematic of GABAA receptor depicting competitive antagonism between flumazenil and midazolam at the benzodiazepine (BZD) binding site. Flumazenil acts as a negative allosteric modulator of GABA by facilitating closure of the chloride ion (Cl−) channel and preventing the influx of Cl− ions.
Michelle Wong
<bold>Figure 1. </bold>
Figure 1. 

Schematic of GABAA receptor depicting competitive antagonism between flumazenil and midazolam at the benzodiazepine (BZD) binding site. Flumazenil acts as a negative allosteric modulator of GABA by facilitating closure of the chloride ion (Cl−) channel and preventing the influx of Cl− ions.

Suspected Accidental Infiltration of Rocuronium During General Anesthesia Induction: A Case Report
Yuya SakuraiDDS,
Makiko ShibuyaDDS, PhD,
Ryuichi OkijiDDS,
Yuri HaseDDS, PhD,
Takayuki HojoDDS, PhD,
Yukifumi KimuraDDS, PhD, and
Toshiaki FujisawaDDS, PhD
Article Category: Case Report
Volume/Issue: Volume 70: Issue 3
Online Publication Date: Oct 18, 2023
DOI: 10.2344/anpr-70-02-01
Page Range: 116 – 119

was observed. Approximately 115 minutes after the suspected infiltration, spontaneous ventilations resumed and continued regularly with a tidal volume of approximately 450 mL and a respiratory rate of approximately 10 breaths/min. Roughly 140 minutes after the suspected infiltration, the TOF ratio was 1.0. Sevoflurane was discontinued at that time, and sugammadex (200 mg) was administered. The patient regained consciousness approximately 7 minutes later and was extubated without difficulty in the operating room. The patient’s respiratory status remained stable