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Korean J Anesthesiol > Epub ahead of print
DOI: https://doi.org/10.4097/kja.22335    [Epub ahead of print]
Published online August 18, 2022.
Cardiac arrest due to coronary vasospasm after sugammadex administration -A case report-
Ki Yung Boo1, Sang Hyun Park2, Sun Kyung Park2, Changrock Na3, Hyun Jung Kim2 
1Department of Cardiology, Jeju National University Hospital, Jeju, Korea
2Department of Anesthesiology and Pain Medicine, Jeju National University College of Medicine, Jeju, Korea
3Department of Anesthesiology and Pain Medicine, Jeju National University Hospital, Jeju, Korea
Corresponding author:  Hyun Jung Kim, Tel: 82-64-717-2026, Fax: 82-64-717-1131, 
Email: hjanesthesia@empas.com
Received: 7 June 2022   • Revised: 28 July 2022   • Accepted: 16 August 2022
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 repeated 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.
Key Words: Anesthesia; Cardiopulmonary Resuscitation; Coronary Angiography; Coronary Vasospasm; Heart Arrest; Sugammadex
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