Analysis of a case of perinatal anaphylactic shock caused by esketamine
- VernacularTitle:1例艾司氯胺酮致围产期过敏性休克的病例分析
- Author:
Liangfen WANG
1
,
2
;
Mengjie HE
1
;
Man LIU
2
;
Yue ZHAO
3
Author Information
1. Dept. of Clinical Pharmacy，Sichuan Provincial Maternity and Child Health Care Hospital，Chengdu 610041，China
2. Dept. of Pharmacy，363 Hospital，Chengdu 611730，China
3. Dept. of Pharmacy，Chengdu Gaoxin Zhonghe Hospital of Traditional Chinese Medicine，Chengdu 610059，China
- Publication Type:Journal Article
- Keywords:
esketamine;
anaphylactic shock;
perinatal period;
narcotic drugs
- From:
China Pharmacy
2024;35(18):2299-2303
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To provide a reference for medical staff to timely identify and treat perinatal anaphylactic shock. METHODS The clinical pharmacists participated in the rescue process of anaphylactic shock caused by esketamine during cesarean section anesthesia in a full-term pregnant patient at the Department of Obstetrics and Gynecology of Sichuan Provincial Maternity and Child Health Care Hospital. By consulting the relevant drug instructions and searching the relevant literature， clinical pharmacists assisted physicians in identifying anaphylactic shock and amniotic fluid embolism， analyzing the correlation between the drugs used and adverse reactions， and providing medication education. RESULTS The patient developed hypoxemia and hypotension after anesthesia， and there was no coagulation dysfunction. After symptomatic treatment with adrenaline， the condition rapidly improved， so it was diagnosed as anaphylactic shock. Based on the patient’s medication use and the characteristics of adverse reactions， combined with the National Adverse Drug Reaction Monitoring Center’s criteria for determining the association between drugs and adverse reactions and Naranjo’s evaluation scale， it was comprehensively determined that the suspected allergenic drug causing anaphylactic shock was esketamine. The clinical pharmacist informed the patient that she must inform the physician of the relevant medications for this severe allergic reaction during her later visits. The patient recovered and was discharged on the 6th day after cesarean section. CONCLUSIONS The clinical manifestations of anaphylactic shock and amniotic fluid embolism are similar， and careful differentiation is needed in clinical practice； if a patient experiences a systemic allergic reaction caused by drugs， the suspected drugs should be stopped promptly and effective symptomatic treatment should be taken immediately to delay or terminate disease progression and ensure the patient’s life safety.
