Ephedrine is a sympathomimetic amine used to treat hypotension. The onset time of neuromuscular blocking agents (NMBA) is influenced by muscle blood flow and cardiac output, and ephedrine can reduce the onset time of NMBAs by increasing these variables. Moreover, ephedrine seems to increase acetylcholine release and is used to treat congenital myasthenic syndromes. We report an unexpected case of reparalysis following ephedrine administration. This report is written with the patient's signed consent.A 63-yr-old male (83 kg, 174 cm) underwent anterior resection for rectal cancer. After anesthesia induction with propofol and remifentanil, muscle relaxation was achieved with rocuronium 50 mg. Anesthesia was maintained with desfmrane and epidural 0.375% ropivacaine.
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