Emergency sugammadex reversal in an 850-g premature infant: A case report

Proshad N. Efune, Gijo Alex, Sonia D. Mehta

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Sugammadex is a novel reversal agent for the neuromuscular blocking agents rocuronium and vecuronium; it has been shown to rapidly and completely reverse neuromuscular blockade for rocuronium and vecuronium, even when the blockade is profound. We present the case of a 2-week-old, 850-g infant born at 25 weeks’ gestation, who presented to the operating room for exploratory laparotomy and repair of ileal atresia. Anesthesia was induced and neuromuscular blockade with 1.2 mg/kg of rocuronium was administered. The neonate experienced rapid oxyhemoglobin desaturation and progressively became very difficult to mask ventilate. Direct laryngoscopy failed to result in successful intubation of the trachea and ventilation became impossible. To reverse the effects of rocuronium, 16 mg/kg of sugammadex was administered. Immediately after, the infant resumed spontaneous ventilation and was able to maintain adequate oxyhemoglobin saturation between 90% and 95% with supplemental oxygen. To our knowledge, this is the first report of successful reversal of neuromuscular blockade, with sugammadex, in an emergent situation after failure to intubate/ventilate an extremely low birth weight infant.

Original languageEnglish (US)
Pages (from-to)107-110
Number of pages4
JournalJournal of Pediatric Pharmacology and Therapeutics
Issue number1
StatePublished - 2021


  • Antidote
  • Case report
  • Extremely low birth weight infant
  • Neuromuscular blockade reversal
  • Neuromuscular blocker
  • Rocuronium
  • Sugammadex

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pharmacology (medical)


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