The use of sugammadex to reverse rocuronium‐induced anaphylaxis in the intensive care unit

Summary Rocuronium is increasingly used as the neuromuscular blocking agent of choice in the ICU due to a favourable side effect profile compared with suxamethonium. However, it potentially causes anaphylaxis with one in every 2499 patient exposures. Reports in anaesthetic literature describe the use of sugammadex as a novel treatment for rocuronium‐induced anaphylaxis, but it is not recommended for routine use. No literature specifically relating to ICU patients exists. We describe a case of severe rocuronium‐induced anaphylaxis on ICU, resistant to conventional therapy and resulting in cardiac arrest, being completely reversed by 200 mg sugammadex.