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Sugammadex (Bridion®), a synthetic gamma-cyclodextrin molecule, is a selective-binding reversal drug that antagonizes neuromuscular blockade induced by steroidal neuromuscular blocking agents (NMBA) rocuroniumand vecuronium-bromide. According to current literature clinical studies with sugammadex in the pediatric population seems to be scarce. The absence of clinical studies contributes to restrained use. A 13-month-old female infant presented at the emergency department with the diagnosis of aspiration of a foreign body. An urgent bronchoscopy under general anesthesia was planned for extraction, accordingly. Induction and maintenance of anesthesia was achieved totally intravenously with propofol and sufentanyl. Rocuronium was administered as a neuromuscular blocker in order to facilitate atraumatic introduction of the rigid bronchoscope and to provide adequate surgical conditions by preventing involuntary movements of the patient during extraction of the foreign body. Removal of the foreign body was successful within minutes. Sugammadex was subsequently administered at a dose of 4mg.kg in order to avoid unnecessary prolonged anesthesia and mechanical ventilation. The neuromuscular block was promptly reversed, regaining spontaneous ventilation. No adverse events occurred up until her discharge, the following day. Conclusion: In this 13-month-old infant sugammadex promptly reversed the deep neuromuscular block induced by rocuronium. No adverse events were noted.

Sugammadex Reverses Safely and Effectively a Profound Neuromuscular Block in an Infant with Foreign Body Inhalation