{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T04:15:44Z","timestamp":1728360944241},"reference-count":11,"publisher":"American Dental Society of Anesthesiology (ADSA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023]]},"abstract":"<jats:p>There are few reports on rocuronium infiltration under general anesthesia. We report a case of suspected accidental rocuronium infiltration during anesthesia induction. A 25-year-old woman with autism spectrum disorder, intellectual disability, and epilepsy was scheduled for the extraction of 4 impacted third molars under general anesthesia. After induction with sevoflurane, an intravenous (IV) line was established in the left cephalic vein. Rocuronium was administered; however, subcutaneous swelling at the IV site was observed immediately. Spontaneous ventilations were maintained until additional rocuronium was administered via a new IV line. After heat pack application, the swelling disappeared 60 minutes after infiltration, and no tissue damage was observed. A strategy was developed to continue neuromuscular monitoring until recovery occurred. Acceleromyography was used, and the train-of-4 ratios at 99, 130, and 140 minutes after infiltration were 0.79, 0.91, and 1.0, respectively. Sugammadex was administered to prevent neuromuscular blockade recurrence. The patient was extubated once adequate return of muscle function and consciousness were observed. No neuromuscular block prolongation or recurrence were observed postoperatively. When rocuronium infiltration is suspected, it is important to eliminate swelling at the infiltration site and determine a management strategy based on neuromuscular monitoring.<\/jats:p>","DOI":"10.2344\/anpr-70-02-01","type":"journal-article","created":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T12:05:55Z","timestamp":1697630755000},"page":"116-119","source":"Crossref","is-referenced-by-count":1,"title":["Suspected Accidental Infiltration of Rocuronium During General Anesthesia Induction: A Case Report"],"prefix":"10.2344","volume":"70","author":[{"given":"Yuya","family":"Sakurai","sequence":"first","affiliation":[{"name":"Department of Dental Anesthesiology, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Makiko","family":"Shibuya","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryuichi","family":"Okiji","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology and Perioperative Management, Hinode Makomanai Dental Hospital, Sapporo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuri","family":"Hase","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takayuki","family":"Hojo","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukifumi","family":"Kimura","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshiaki","family":"Fujisawa","sequence":"additional","affiliation":[{"name":"Department of Dental Anesthesiology, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1191","reference":[{"key":"i1878-7177-70-3-116-b01","series-title":"JA Clin Rep","first-page":"1","article-title":"Prolonged onset and duration of action of rocuronium after accidental subcutaneous injection in a patient with chronic renal failure\u2014a case report","volume":"7","author":"Kajiura","year":"2021","unstructured":"Kajiura\n              DA,\n       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Eng.\n2020;\n3:\n16\u201319."},{"key":"i1878-7177-70-3-116-b03","series-title":"J Anaesth Crit Care Case Rep","first-page":"21","article-title":"Successful management of subcutaneous infiltration of an intubating dose of rocuronium in a morbidly obese patient: a case report","volume":"4","author":"Awad","year":"2018","unstructured":"Awad\n              N,\n            \n            \n              Zalut\n              S,\n            \n            \n              Deutsch\n              E.\n            \n          \n          Successful management of subcutaneous infiltration of an intubating dose of rocuronium in a morbidly obese patient: a case report.\nJ Anaesth Crit Care Case Rep.\n2018;\n4:\n21\u201323."},{"key":"i1878-7177-70-3-116-b04","series-title":"A&A Pract","first-page":"375","article-title":"Sugammadex reversal of a large subcutaneous depot of rocuronium in a dialysis patient: a case report","volume":"12","author":"Navare","year":"2019","unstructured":"Navare\n              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extravasations","volume":"43","author":"Ong","year":"2020","unstructured":"Ong\n              J,\n            \n            \n              Van Gerpen\n              R.\n            \n          \n          Recommendations for management of noncytotoxic vesicant extravasations.\nJ Infus Nurs.\n2020;\n43:\n319\u2013343."},{"key":"i1878-7177-70-3-116-b08","series-title":"Acta Anaesthesiol Scand","first-page":"1082","article-title":"Onset time and duration of action of rocuronium 0.6 mg\/kg in patients above 80 years of age: a comparison with young adults","volume":"64","author":"Bjerring","year":"2020","unstructured":"Bjerring\n              C,\n            \n            \n              Vested\n              M,\n            \n            \n              Arleth\n              T,\n            \n            \n              Eriksen\n              K,\n            \n            \n              Albrechtsen\n              C,\n            \n            \n              Rasmussen\n              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randomized clinical comparative study in an Asian population.\nBMC Anesthesiol.\n2015;\n16:\n65."},{"key":"i1878-7177-70-3-116-b10","series-title":"Anesthesiology","first-page":"109","article-title":"Rocuronium-induced neuromuscular block is affected by chronic carbamazepine therapy","volume":"90","author":"Spacek","year":"1999","unstructured":"Spacek\n              A,\n            \n            \n              Neiger\n              FX,\n            \n            \n              Krenn\n              CG,\n            \n            \n              Hoerauf\n              K,\n            \n            \n              Kress\n              HG.\n            \n          \n          Rocuronium-induced neuromuscular block is affected by chronic carbamazepine therapy.\nAnesthesiology.\n1999;\n90:\n109\u2013112."},{"key":"i1878-7177-70-3-116-b11","series-title":"Chest","first-page":"A1969","article-title":"Propofol extravasation: a case of soft tissue injury","volume":"156","author":"Ivanovic","year":"2019","unstructured":"Ivanovic\n              S,\n            \n            \n              Cohen\n              J,\n            \n            \n              Twal\n              AA,\n            \n            et al.\n          \n          Propofol extravasation: a case of soft tissue injury.\nChest.\n2019;\n156:\nA1969\u2013A1970."}],"container-title":["Anesthesia Progress"],"original-title":[],"link":[{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/view\/journals\/anpr\/70\/3\/article-p116.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/meridian.allenpress.com\/anesthesia-progress\/article-pdf\/70\/3\/116\/3278290\/i1878-7177-70-3-116.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/downloadpdf\/journals\/anpr\/70\/3\/article-p116.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/downloadpdf\/journals\/anpr\/70\/3\/article-p116.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,7]],"date-time":"2024-10-07T12:44:51Z","timestamp":1728305091000},"score":1,"resource":{"primary":{"URL":"https:\/\/anesthesiaprogress.kglmeridian.com\/view\/journals\/anpr\/70\/3\/article-p116.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023]]},"references-count":11,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.2344\/anpr-70-02-01","relation":{},"ISSN":["1878-7177","0003-3006"],"issn-type":[{"type":"electronic","value":"1878-7177"},{"type":"print","value":"0003-3006"}],"subject":[],"published":{"date-parts":[[2023]]}}}