A young woman known with end-stage heart failure and renal and liver abnormalities underwent cardiopulmonary resuscitation.zSeven hours after administration of 1.2mg/kg of rocuronium, acceleromyography still showed a complete neuromuscular block.zAfter administration of rocuronium-antagonist sugammadex (16mg/kg), she could promptly move upon commands. Several of the publishedzrisk factors for block prolongation were present in our patient. To our knowledge, this is the first time that sugammadex reversedzan extremely prolonged rocuronium-induced neuromuscular block. This case underscores the importance of recognizing neuromuscularzblock prolongation in ICU patients. In such instances testing for the presence of residual paralysis and the administration of sugammadexzas a novel direct antagonist for rocuronium should be considered. 2011, Nederlandse Vereniging voor Intensive Care.