Sugammadex Administration to Facilitate Timely Neurologic Examination in the Traumatic Brain Injury Patient

NCJ_cover.jpgBy Jonathan M. Curley, David P. Ciceri, William C. CulpJr.

First Online: 02 January 2020

Neuromuscular blocking agents are frequently administered to traumatic brain injury patients during initial airway management; however, paralytics can delay diagnosis and treatment by impeding the neurologic examination. Sugammadex is a relatively new medication approved for reversal of amino-steroid paralytic agents such as rocuronium or vecuronium. We describe the use of sugammadex to reverse prolonged rocuronium-induced paralysis in a dialysis-dependent patient who suffered a traumatic brain injury. This reversal allowed for immediate evaluation by a neurosurgeon, neurosurgical intervention, and subsequent detection of patient neurologic deterioration by examination which otherwise may have been mistaken for prolonged paralysis. To the authors’ knowledge, the use of sugammadex for this purpose has not previously been reported.

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