Abstract
We report on a patient who presented with recurrent severe shock during general anesthesia. The patient was a man scheduled for lung surgery whose first attack was a coronary spasm, which was followed by a second shock with severe bronchospasm and hypotension 4 weeks later. An elevated serum tryptase concentration was observed, and subsequent skin testing revealed negative reactions to some drugs administered in this case. This case serves to alert anesthetists to the possibility of some different forms of allergy and highlights the importance of rigorous investigation of all the reagents and phenomena.
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References
Fisher MM, Baldo BA. Anaphylaxis during anaesthesia current aspects of diagnosis and prevention. Eur J Anaesthesiol. 1994;11:263–84.
Laxenaire MC, The Members of the Writing Committee. Drugs and other agents involved in anaphylactic shock occurring during anaesthesia. A French multicenter epidemiological inquiry. Ann Fr Anesth Reanim. 1993;12:91–6.
Mertes PM, Laxenaire MC. Allergic reactions occurring during anaesthesia. Eur J Anaesthesiol. 2002;19:240–62.
Osugi T, Ueki R, Shimode N, Takara T, Tashiro C. Blood transfusion-induced anaphylaxis and coronary artery spasm during general anesthesia. J Anesth. 2008;22:457–9.
Fujita Y, Chikamatsu M, Kimura M, Toriumi T, Endoh S, Sari A. An anaphylactic reaction possibly associated with an intraoperative coronary spasm during general anesthesia. J Clin Anesth. 2001;13:221–6.
Laxenaire MC, Mertes PM. Anaphylaxis during anaesthesia. Results of a two-year survey in France. Br J Anaesth. 2001;87:549–58.
Fisher NM, Baldo BA. Mast cell tryptase in anaesthetic anaphylactoid reactions. Br J Anaesth. 1998;80:26–9.
Mertes PM, Laxenaire MC, Lienhart A, Aberer W, Ring J, Pichler WJ, et al. Reducing the risk of anaphylaxis during anesthesia: guidelines for clinical practice. J Investig Allergol Clin Immunol. 2005;15:91–101.
Mertes PM, Laxenaire MC, Alla F. Anaphylactic and anaphylactoid reactions occurring during anesthesia in France in 1999–2000. Anesthesiology. 2003;99:536–45.
Kroigaard M, Garvey LH, Menne T, Husum B. Allergic reactions in anaesthesia: are suspected causes confirmed on subsequent testing? Br J Anaesth. 2005;95:468–71.
Zucker-Pinchoff B, Ramanayhan S. Anaphylactic reaction to epidural fentanyl. Anesthesiology. 1989;71:599–601.
Cummings KC 3rd, Arnaut K. Case report: Fentanyl-associated intraoperative anaphylaxis with pulmonary edema. Can J Anesth. 2007;54:301–6.
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Imanishi, H., Kitamura, A., Maruyama, K. et al. Suspected recurrent anaphylaxis in different forms during general anesthesia. J Anesth 24, 143–145 (2010). https://doi.org/10.1007/s00540-009-0839-z
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DOI: https://doi.org/10.1007/s00540-009-0839-z