Recurrent unilateral lung ventilation disorder in a patient that experienced rocuronium-induced anaphylactic bronchospasm during laparoscopic rectal surgery: A case report.
10.4097/kjae.2010.59.4.275
- Author:
Won Joon CHOI
1
;
Soo Il CHOI
;
Jeong Min MOK
;
Hyun Soo KIM
;
Yun Hong KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. yhkim12@yahoo.co.kr
- Publication Type:Case Report
- Keywords:
Anaphylaxis;
Bronchial spasm;
Laparoscopic surgery;
Rocuronium
- MeSH:
Anaphylaxis;
Androstanols;
Atracurium;
Bronchial Spasm;
Emergency Treatment;
Head-Down Tilt;
Humans;
Intradermal Tests;
Intubation;
Laparoscopy;
Lung;
Pneumoperitoneum;
Rectal Neoplasms;
Succinylcholine;
Thiopental;
Vecuronium Bromide;
Ventilation
- From:Korean Journal of Anesthesiology
2010;59(4):275-278
- CountryRepublic of Korea
- Language:English
-
Abstract:
Rocuronium is the anesthetic agent most likely to cause anaphylaxis. Immediately after intravenous rocuronium administration, the authors experienced ventilatory impairment due to unilateral bronchospasm (left lung), which was relieved by emergency treatment. However, 80 minutes after beginning laparoscopic surgery for rectal cancer, the left lung suddenly re-collapsed under pneumoperitoneum in the Trendelenburg position. A postoperative intradermal test revealed that rocuronium, vecuronium, atracurium, succinylcholine, or thiopental could induce anaphylaxis in this patient, but it was not established whether the second incident during surgery was due to endobronchial intubation or anaphylactic bronchospasm. This case cautions that under pneumoperitoneum in the Trendelenburg position, patients suspected of being prone to anaphylactic bronchospasm should also be considered at risk of endobronchial intubation.
