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- Title
"Off-label use" of sugammadex in a neonate.
- Authors
Wunderer, F.; L'Allemand, N.; Kaufmann, J.; Zacharowski, K.; Piekarski, F.
- Abstract
While the use of the specific antidote sugammadex to reverse a non-depolarising neuromuscular block by rocuronium in adults and older children has been established throughout Europe over the last decade, its use in toddlers under the age of two years has not been approved. We present the case of a neonate who experienced an accidental rocuronium overdose during general anaesthesia for elective inguinal herniotomy and developed an extended neuromuscular block after the operation. To avoid the risks of prolonged postoperative ventilation and sedation, the decision was made to reverse the rocuronium-induced neu-romuscular block with sugammadex as an off-label use after thorough risk assessment. The benefit of this specific off-label use was considered to outweigh the formal uncertainty and potential side effects in this actual clinical situation. In the absence of strong evidence, offlabel treatment in children can become an ethical dilemma. In this case, a particularly careful and individual riskbenefit assessment on an evidencebased basis must be demanded of the prescriber.
- Publication
Anaesthesiologie & Intensivmedizin, 2021, Vol 62, Issue 6, p293
- ISSN
0170-5334
- Publication type
Article
- DOI
10.19224/ai2021.293