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Anticholinesterase does not allow
adequate reversal of the deep neuromuscular blockade (NMB) achieved using high
doses of relaxants. A 71-year-old female patient (weight 70 kg, height 169 cm)
was scheduled for a transurethral resection of a bladder tumor under general anesthesia. We
administered rocuronium 30 mg (0.43 mg/kg) for tracheal intubation due to an estimated short
surgical time. During the operation, an additional rocuronium 10 mg was
injected. The surgical procedure ended abruptly 10 minutes after receiving the
last dose of rocuronium. At the end of surgery, the patient received
pyridostigmine as a reversal. However, residual NMB persisted, and
neuromuscular monitoring did not show the expected degree of recovery.
Sugammadex 2 mg/kg was used, and the patient experienced complete reversal from
NMB in just 2 min.