Anesthetic Considerations During Unanticipated 'depot' Dose Of Rocuronium Due To Intravenous Line Infiltration.

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Conference Proceeding

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A 60-year-old man w/ PMHx of primary hyperthyroidism presented for parathyroid exploration and excision. A non-RSI induction with lidocaine, propofol, and rocuronium was started through a free flowing 20-gauge PIV. Despite 200mg of propofol, he showed no evidence of sedation or discomfort at the IV site. Subsequent untucking of his left arm revealed a large subcutaneous weal. New IV access was established while monitoring for potential conscious paralysis from subcutaneous rocuronium. The case continued without additional intraoperative or postoperative complications, including recurarization following sugammadex reversal. We will discuss the management of and the available literature on subcutaneously delivered rocuronium.


American Society of Anesthesiology Annual Meeting, New Orleans, LA, October 21-25, 2022.