Neuromuscular blocking agents, particularly rocuronium, are a major cause of perioperative anaphylaxis. This report presents a rare and severe case of rocuronium-induced anaphylaxis in a 50-year-old woman undergoing an elective total laparoscopic hysterectomy at a tertiary care center in Eastern Nepal. Despite multiple doses of intravenous epinephrine, the patient did not achieve adequate hemodynamic recovery. However, a single bolus of sugammadex resulted in the rapid and complete resolution of symptoms. This case highlights the potential of sugammadex as a life-saving adjunct in treating NMBA-induced anaphylaxis that is unresponsive to standard inter ventions.
Keywords: Rocuronium, sugammadex, anaphylaxis, epinephrine, refractory