Anaphylactic Shock Following Intravenous Injection of Cisatracurium and Sufentanil During Anesthesia Induction.
- Author:
Hyun Jee KIM
1
;
Jin Hong BAE
;
Kyung Hwa KWAK
Author Information
1. Department of Anesthesiology and Pain Medicine, Keimyung University School of Medicine, Daegu, Korea. hjkim@dsmc.or.kr
- Publication Type:Original Article
- Keywords:
Anaphylaxis;
Anesthesia;
Cisatracurium;
Shock;
Sufentanil
- MeSH:
Airway Obstruction;
Anaphylaxis*;
Anesthesia*;
Anesthesia, General;
Anti-Bacterial Agents;
Bronchial Spasm;
Diagnosis;
Epinephrine;
Erythema;
Humans;
Hydrocortisone;
Hypotension;
Injections, Intravenous*;
Latex;
Neuromuscular Blocking Agents;
Pheniramine;
Shock;
Skin Manifestations;
Skin Tests;
Sufentanil*
- From:Keimyung Medical Journal
2014;33(2):140-145
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Anaphylaxis under general anesthesia is rare but can present as cardiovascular collapse, airway obstruction, and/or skin manifestation. A high level of suspicion is required for the recognition and prompt management and anaphylaxis can be diagnosed through clinical findings. The most common causes of anaphylaxis during general anesthesia are neuromuscular blocking agents, antibiotics, and latex. We present a case of anaphylactic shock following intravenous injection of cisatracurium and sufentanil. The patient was under anesthesia induction and within minutes after injection of these drugs, generalized erythema, bronchospasm, and severe hypotension developed. The Patient was managed with epinephrine, proper hydration, hydrocortisone, and pheniramine and the surgery was decided to be postponed. Subsequent surgery should be performed after conducting skin tests which can help identify the causal agents and determine alternative drugs. Anesthesiologists should be aware that not only expeditious diagnosis and management of anaphylaxis but also further evaluation in order to determine the safe method of subsequent anesthesia.
