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Case Reports in Anesthesiology
Volume 2014 (2014), Article ID 135032, 3 pages
Case Report

Negative Pressure Pulmonary Edema after Reversing Rocuronium-Induced Neuromuscular Blockade by Sugammadex

1Department of Anesthesiology, Musashikosugi Hospital, Nippon Medical School, 1-396 Kosugi-cho, Nakahara-ku, Kanagawa 211-8533, Japan
2Department of Anesthesiology, Higashitotuka Memorial Hospital, 548-7 Shinano-cho, Totsuka-ku, Yokohama-shi, Kanagawa 244-0801, Japan
3Department of Surgery, Higashitotuka Memorial Hospital, 548-7 Shinano-cho, Totuka-ku, Yokohama-shi, Kanagawa 244-0801, Japan

Received 11 December 2013; Accepted 8 January 2014; Published 13 February 2014

Academic Editors: A. Han and T. Suzuki

Copyright © 2014 Manzo Suzuki et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Negative pressure pulmonary edema (NPPE) is a rare complication that accompanies general anesthesia, especially after extubation. We experienced a case of negative pressure pulmonary edema after tracheal extubation following reversal of rocuronium-induced neuromuscular blockade by sugammadex. In this case, the contribution of residual muscular block on the upper airway muscle as well as large inspiratory forces created by the respiratory muscle which has a low response to muscle relaxants, is suspected as the cause.