SUGAMMADEX: A NOVEL APPROACH IN THE MANAGEMENT OF ROCURONIUM-INDUCED ANAPHYLAXIS DURING ANESTHESIA INDUCTION

Anaphylaxisis a rapid-onset, potentially life-threateningsystemichypersensitivityreaction, with an estimated incidence of 1 in 20,000 anesthetic administrations. Neuromuscularblocking agents (NMBAs), particularlyrocuronium and succinylcholine, are implicatedin 60–70% of anestheticanaphylaxis cases. Prompt recognition and intervention are critical in these emergencies. Sugammadex, a selectiveantagonist of rocuronium, offers a noveltherapeuticapproach due to itsability to rapidlyencapsulaterocuroniummolecules, effectivelymitigating the immunologicalprocessesdrivinganaphylaxis. This report presents a 46-year-old womanwhodevelopedrocuronium-inducedanaphylaxisduringcholecystectomy. Manifesting as severe hypotension and urticarialerythemashortlyafter induction, her condition wasunresponsive to initial resuscitativemeasures. Administration of sugammadexpromptlyreversed the reaction, restoringhemodynamicstability and resolvingsymptoms. Allergytestingsubsequentlyconfirmedrocuronium as the causative agent. The discussion explores the pathophysiology, diagnostic challenges, and biochemical investigations pertinent to NMBA-inducedanaphylaxis. A review of the literature supports sugammadex as an emergingtherapeutic option, particularly in refractory cases. This case underscores the necessity of timelydiagnosis and intervention, emphasizingsugammadexsrole in enhancing patient safetyduringanesthesia. Furtherresearch and clinical vigilance are essential to optimizeoutcomes in NMBA-inducedanaphylaxis.