Sugammadex hypersensitivity: a multicentre retrospective analysis of a large Australian cohort
Authors' conclusion
Sugammadex hypersensitivity presents similarly to other causes of perioperative hypersensitivity, however recognition can be delayed. The combination of positive serum tryptase and positive skin tests suggests an IgE-mediated mechanism of hypersensitivity. The estimated incidence of sugammadex hypersensitivity in Australia is lower than earlier reports.
Study context
- Population
- Perioperative sugammadex hypersensitivity diagnosed by positive intradermal or skin prick testing at six perioperative allergy clinics in Australia
- Participants
- 30 participants
- Exposure
- Life-threatening vs non-life-threatening presentations
- Life-threateningn = 15
- Non-life-threateningn = 15reference
- Outcome
- Clinical and diagnostic features of perioperative sugammadex hypersensitivity
Main finding
As reported in the abstract
Clinical and diagnostic features
| Group | Value | Tryptase positive |
|---|---|---|
| Life-threatening | 100% | 15 (100%) |
| Non-life-threatening | 69.2% | 9 (69.2%) |
Value
Life-threatening100%
Non-life-threatening69.2%
Tryptase positive
Life-threatening15 (100%)
Non-life-threatening9 (69.2%)
- Hypotension
- n=25, 83.3%
- Flushing/erythema
- n=21, 70%
- Median time to recognition of hypersensitivity, min (IQR)
- 5 (2-7.5)
- Cases recognised 10-30 min after administration
- 5
- Serum tryptase measured
- 28 (93.3%)
Observational data: associations, not effects.
Further findings
Estimated incidence of sugammadex hypersensitivity (two health services, Jan 1, 2010–Jun 30, 2023)
- Estimated incidence
- 0.004% (95% CI 0.002-0.008%)
Original publication
Sugammadex hypersensitivity: a multicentre retrospective analysis of a large Australian cohort. Br J Anaesth. Published 15 October 2024. doi:10.
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