Recurarization after sugammadex reversal in a preeclamptic parturient receiving magnesium sulfate and general anesthesia with rocuronium: a case report
Fernando Chuluck Silva, Monica Maria Siaulys, Marina Cestari de Rizzo
Abstract
Residual neuromuscular blockade is a risk when combining neuromuscular blockers and magnesium. We report a pregnant patient with severe preeclampsia receiving magnesium sulfate who underwent emergency cesarean section under general anesthesia with rocuronium. Following sugammadex reversal, initial TOFratio reached 98%. After 40 minutes, she developed dyspnea and weakness, with TOFratio dropping to 43%. Two more doses of sugammadex (cumulative 600 mg) restored neuromuscular function (TOFratio 99%) and symptoms. No anesthetic complications were observed in the newborn; NICU transfer was indicated for prematurity. This case highlights the potential for recurarization in patients treated with magnesium sulfate, requiring vigilant postoperative monitoring.
Keywords
References
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Submitted date:
05/09/2026
Accepted date:
07/31/2026
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