Effective treatment of hypotension during induction of general anesthesia depends onhow well the many causes of the hypotension are understood. However, differential diagnosis of hypotension is by no means easy, especially when the prevalenceof hypotension is low or when the patient is asymptomatic. A 75 year-old female, upon induction of general anesthesia for open thoracic surgery, became hypotensive and showed generalized erythematous papules, therefore having to postpone the surgery. Upon further evaluation through skin prick tests, the hypotensive event was concluded to be caused by anaphylactic side effects of atracurium. Hence, atracurium was avoided and the surgery was successfully performed.
Anaphylaxis ; Anesthesia, General ; Atracurium ; Diagnosis, Differential ; Female ; Humans ; Hypotension ; Skin ; Thoracic Surgery

One-lung ventilation with a double-lumen endotracheal tube or a Univent(R) tube may be difficult or dangerous in small patients, children, and patients with anatomic abnormalities of the airway. The use of a bronchial blocker through a single-lumen endotracheal tube has been used successfully in such situations. A 69-year-old woman was scheduled for Ivor-Lewis operation and right upper lobectomy. She could not be intubated with a internal diameter 6.0 mm Univent(R) tube owing to narrow diameter of the vocal cord. We report a successful one-lung ventilation using a Uniblocker(R) through an adult-size single-lumen endotracheal tube in a small woman, who needed postoperative ventilator care.
Aged ; Child ; Female ; Humans ; One-Lung Ventilation ; Ventilators, Mechanical ; Vocal Cords