Sugammadex reversal of an accidental rocuronium overdose in a dog in the context of incivility in the workplace.

Sugammadex effectively reverses severe rocuronium overdose in dogs without hemodynamic compromise.

This case report describes successful management of a significant rocuronium overdose in a 7-year-old mixed-breed dog undergoing craniotomy for brain mass excision. During anesthetic preparation, workplace pressure led to a medication calculation error resulting in a 60-fold rocuronium overdose rate. After 120 minutes of continuous infusion, the error was identified and stopped. Sugammadex (1 mg/kg IV) was administered 270 minutes post-infusion cessation, rapidly reversing neuromuscular blockade with spontaneous ventilation returning within one minute and hemodynamically stable tracheal extubation 60 minutes later. This case demonstrates sugammadex's efficacy in managing severe rocuronium overdose in canine patients and validates its use as a rescue agent for deep neuromuscular blockade. The authors emphasize that workplace incivility contributed to medication preparation errors, highlighting the importance of implementing standardized operating procedures and safety practices in veterinary anesthesia to prevent similar incidents.

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