Reversal of moderate and intense neuromuscular block induced by rocuronium with low doses of sugammadex for intraoperative facial nerve monitoring

We report two cases in which moderate and intense rocuronium-induced neuromus-cular block was reversed intraoperatively with low sugammadex doses in order to facilitate electromyographic evaluation of facial nerve function during surgery of the parotid gland Rocuronium; and the middle ear. Acceleromyography was used to assess reversal of neuromuscular block Sugammadex; before starting electromyography monitoring. Rocuronium-induced neuromuscular block was reversed with sugammadex 0.22 mg kg( -1) when the TOF ratio was 0.14 in the first patient, and nerve monitoring with sugammadex 2 mg kg(-1) during intense block (PTC 0) in the second patient. In each case, appropriate neuromuscular function (TOF ratio >= 0.9) was established soon after sugammadex administration, and electromyographic evaluation of facial nerve was successfully conducted. The use of rocuronium and sugammadex, coupled with objective neuromuscular monitoring with acceteromyography, assured complete restoration of neuromuscular function and created the optimal conditions for the surgical team. (C) 2012 Sociedad Espanola de Anestesiologia, Reanimacion y Terapeutica del Dolor. Published by Elsevier Espana, S.L. All rights reserved.