Rocuronium anaphylaxis

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Kierzek G, Audibert J, Pourriat JL. Anaphylaxis after rocuronium. Eur J Anaesthesiol 2003 20(2) 169-70. 

Joseph P, Benoit Y, Gressier M, Blanc P, Lehot JJ. Accident anaphylactique apres administration de rocuronium interet du bilan primaire pour le diagnostic precoce. [Anaphylaxis after rocuronium advantage of blood tests for early diagnosis.] Ann Fr Anesth Reanim 2002 21(3) 221-3. 

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C. Known hypersensitivity or anaphylactic reaction (non-dose-related) to agent or presenrative (eg, benzyl alcohol). Succinylcholine is most commonly implicated, but anaphylaxis has been reported with rocuronium, atracurium, mi-vacurium, and cisatracurium. 

Baldo BA, McDonnell NJ, Pheun NH. Drug-specific cyclodextrans with emphasis on sugammadex, the neuromuscular blocker rocuronium and perioperative anaphylaxis impUcations for drug aUeigy. Clin Exp AUeigy. 2011 41 1663-78. 

Fig. 7.15 Chemical structure of one of the eight a-1-4-linked glucopyranose units of sugammadex, 6-perdeoxy-6-per(2-carboxyethyl)thio-Y-cyclodextrin sodium salt, showing the thio(2-carboxyethyl)sodium group linked at position 6 of the glucose molecule. From Baldo BA et al. Drug-specific cyclodextrins with emphasis on sugammadex, the neuromuscular blocker rocuronium and perioperative anaphylaxis implications for drug aUeigy. Qin Exp Allergy 2011 41 1663. Reprinted with permission from lohn Wiley and Sons...

Fig. 7.16 Two-dimensional chemical stracture and space-fiUing CPK molecular model of rocuronium showing the 11 A distance between the C3 atom on ring A of the gonane nucleus and the C16 atom on ring D. The propenyl (aUyl) pyrroUdin-ium quaternary ammonium group is shown in magenta on the two-dimensional structure and the CPK model. See also Figs. 7.14b and 7.17 for the significance of the 11 A distance. From Baldo BA et al. The cyclodextrin sugammadex and anaphylaxis to rocuronium Is rocuronium stUl potentially allergenic in the inclusion complex form Mini Rev Med Chem 2012 12 701. Reprinted with permission from Bentham Science Publishers...

Baldo BA, McDonnell NJ, Pham NH. The cyclodextrin sugammadex and anaphylaxis to rocuronium is rocuronium still potentially allergenic in the inclusion complex form Mini Rev Med Chem. 2012 12 701-12. 

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