Anaphylactic reaction with hydroxyethyl starch during anesthesia: A case report
10.17085/apm.2019.14.4.412
- Author:
Gunnhee KIM
1
;
Goeun KIM
;
Miyoung KWON
;
Minseok KOO
;
Mijung YUN
Author Information
1. Department of Anesthesiology and Pain Medicine, National Medical Center, Seoul, Korea. mijung.yun@nmc.or.kr
- Publication Type:Case Report
- Keywords:
Anaphylaxis;
Anesthesia, Spinal;
Starch
- MeSH:
Aged, 80 and over;
Anaphylaxis;
Anesthesia;
Anesthesia, Spinal;
Colloids;
Dexamethasone;
Diagnosis;
Dihydroergotamine;
Exanthema;
Humans;
Hydrocortisone;
Hypersensitivity;
Hypotension;
Hypovolemia;
Immunoglobulin E;
Immunoglobulins;
Phenylephrine;
Plasma;
Starch;
Tryptases;
Vital Signs
- From:Anesthesia and Pain Medicine
2019;14(4):412-415
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Hydroxyethyl starch (HES), a class of synthetic colloid solutions, has been widely used to treat perioperative hypovolemia. The use of HES, however, is associated with the risk of allergic reactions.CASE: An 83-year-old man was scheduled to undergo an open reduction and internal fixation of a pertrochanteric fracture under spinal anesthesia. He had no history of allergy. Five minutes after HES administration, hypotension, agitation, and skin rash were developed. HES infusion was terminated due to a suspected anaphylactic reaction. The vital signs recovered following administration of phenylephrine, dexamethasone, and hydrocortisone. Serum tryptase and total immunoglobulin E levels were elevated in plasma samples collected following the commencement of the allergic reaction during surgery.CONCLUSIONS: In the present report, the risk of anaphylactic reaction with HES and the laboratory tests needed to support the diagnosis are highlighted.
