Abstract

ABSTRACT Sugammadex is a safe selective relaxant binding agent, composed of modified cyclodextrin molecules. It especially has a selectivity for neuromuscular blocking agents (NMBAs) of steroid composition, such as rocuronium and vecuronium. In this paper, we present a case where intravenous (iv) sugammadex has been applied and subsequently persistent bradycardia has developed. A 56-year-old male patient (weight 77 kg, height 163 cm) was scheduled for ureterorenoscopy because of a stone in the upper part of ureter. Preoperative examination showed possible difficult intubation (mallampati 3). There are no known heart diseases and no history of any drug use. The 3 electrocardiography was in normal sinus rhythm, and the blood biochemistry was normal. (WBC: 8.47 K/mm ; Hb: 14.3 g/dL; Na: 135 mEq/L; K: 3.9 mEq/L; BUN: 41 mg/dL; Creatin: 0.69 mg/dL).When the operation ended, We monitored neuromuscular block level with a neuromuscular monitoring device (TOF- Watch S). At the end of the operation, 200 mg sugammadex (Bridion 200 mg/2 mL, MSD) was administered to the patient through iv injection. Approximately 2 minutes following the administration, the patient developed sinusoidal bradycardia (pulse 35 beats/min). We believe that cardiac side effects may be observed following sugammadex administration and that atropine-resistant bradycardia may also develop.