Rocuronium antagonized by sugammadex for series of electroconvulsive therapy (ECT) in a patient with pseudocholinesterase deficiency

J ECT. 2011 Mar;27(1):e47-8. doi: 10.1097/YCT.0b013e318205e1d3.

Abstract

We report the anesthetic management of a patient with catatonic schizophrenia and pseudocholinesterase deficiency, using the nondepolarizing neuromuscular blocking drug, rocuronium, reversed by its specific reversal agent, sugammadex, for a series of electroconvulsive therapy sessions. Rocuronium and sugammadex were used every 48 hours for 8 consecutive times and proved to be an effective and safe combination in a situation where succinylcholine was contraindicated.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Androstanols / antagonists & inhibitors*
  • Apnea
  • Butyrylcholinesterase / deficiency
  • Cholinesterases / deficiency
  • Drug Hypersensitivity / complications
  • Drug Interactions
  • Electroconvulsive Therapy*
  • Humans
  • Male
  • Metabolism, Inborn Errors
  • Neuromuscular Nondepolarizing Agents / antagonists & inhibitors
  • Rocuronium
  • Schizophrenia, Catatonic / complications*
  • Schizophrenia, Catatonic / therapy*
  • Sugammadex
  • gamma-Cyclodextrins / therapeutic use

Substances

  • Androstanols
  • Neuromuscular Nondepolarizing Agents
  • gamma-Cyclodextrins
  • Sugammadex
  • Butyrylcholinesterase
  • Cholinesterases
  • Rocuronium

Supplementary concepts

  • Butyrylcholinesterase deficiency