Severe anaphylaxis caused by vancomycin and flurbiprofen axetil
10.3760/cma.j.cn114015-20200708-00751
- VernacularTitle:万古霉素和氟比洛芬酯致严重过敏反应
- Author:
Yi CHEN
1
;
Yingqiu YING
;
Shanshan LI
;
Li YANG
;
Suodi ZHAI
Author Information
1. 北京大学第三医院药剂科，北京 100191；北京大学药学院药事管理与临床药学系，北京 100191
- Publication Type:Journal Article
- Keywords:
Anaphylaxis;
Shock;
Vancomycin;
Flurbiprofen
- From:
Adverse Drug Reactions Journal
2020;22(11):662-664
- CountryChina
- Language:Chinese
-
Abstract:
A 74-year-old male patient underwent posterior lumbar decompression, fusion, and internal fixation under general anesthesia for lumbar spinal stenosis. Sevoflurane (1.5%), propofol, sufentanil, etomidate, and cisatracurium were used for anesthesia, followed by dexamethasone for allergy prevention, cefuroxime for infection prevention, and hydroxyethyl starch for hemodynamic stabilization. Inhalation of sevoflurane (1.5%) and introvenous pumping of remifentanil 300 μg/h and phenylephrine 0.4 mg/h were given for anesthesia maintenance during the operation. The operation process went smoothly and no anaphylaxis occurred within 4 hours. At the end of the operation, vancomycin powder 1 g was given topically at the surgical site and intravenous injection of flurbiprofen axetil 50 mg was given 15 minutes later. Twenty minutes after the medication, the patient′s pulse oxygen saturation was not detectable and the blood pressure fell to 45/20 mmHg. Severe anaphylaxis was diagnosed. The central vein was immediately switched on, and intravenous injection of epinephrine and norepinephrine and intermittently intravenous injection of norepinephrine were given. Ten minutes later, the pulse oxygen saturation returned to 1.00 and 15 minutes later, the blood pressure became stable. At the same time, 2 000 ml of sodium lactate Ringer′s injection was given. The patient was in stable condition 5 hours later and was transferred out of the operating room. The severe anaphylaxis in this patient was considered to be related to vancomycin and flurbiprofen axetil.
