Succinylcholine is widely used for muscle relaxation during Electroconvulsive therapy (ECT) mowing to its rapid onset and short duration of action. However, untoward side effects may occasionally occur, such as prolonged apnea associated with pseudocholinesterase deficiency. In cases where use of succinylcholine is inappropriate, muscle relaxants are needed to achieve a rapid onset of action and fast recovery equal to that is observed with succinylcholine. Sugammadex has a gamma-cyclodextrin structure, and binds to the rocuronium molecules in plasma and neuromuscular junction tightly in a one to one fashion and quickly inhibits the deep neuromuscular block. In this case report, we aimed to share our experience in the use of rocuronium-sugammadex during repeated sessions in a patient who experienced prolonged apnea associated with pseudocholinesterase deficiency during the first ECT. In conclusion, we believe that rocuronium and sugammadex may be used with confidence in cases requiring short procedures such as ECT.
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