Yang Ya-Ling, Huang Hui-Wen, Yip Hon-Kan, Jawan Bruno, Tseng Chia-Chih, Lu Hsiao-Feng
Department of Anesthesiology, Chang Gung Memorial Hospital-Kaohsiung Medical Center and Chang Gung University College of Medicine, Kaohsiung, Taiwan, ROC.
Acta Anaesthesiol Taiwan. 2008 Dec;46(4):184-6. doi: 10.1016/S1875-4597(09)60007-2.
In this case report, we describe a 70-year-old male patient who sustained Kounis syndrome induced by cisatracurium administration immediately following induction of general anesthesia. Acute coronary syndrome combined with anaphylactic shock, termed Kounis syndrome, should be investigated in percutaneous coronary intervention to solve this complex and life-threatening condition. A team effort by cardiologist and anesthesiologist is essential for successful resuscitation. In general, the incidence of an anaphylactic reaction to cisatracurium is low, but a high serum IgE level in combination with a positive skin prick test in our patient was strongly suggestive of cisatracurium-induced Kounis syndrome. In addition, a cross-reaction between cisatracurium and rocuronium is reported.
在本病例报告中，我们描述了一名70岁男性患者，在全身麻醉诱导后立即给予顺式阿曲库铵时发生了库尼斯综合征。急性冠状动脉综合征合并过敏性休克，即库尼斯综合征，在经皮冠状动脉介入治疗中应进行调查，以解决这种复杂且危及生命的状况。心脏病专家和麻醉师的团队协作对于成功复苏至关重要。一般来说，对顺式阿曲库铵发生过敏反应的发生率较低，但我们的患者血清IgE水平升高且皮肤点刺试验呈阳性，强烈提示为顺式阿曲库铵诱发的库尼斯综合征。此外，有报道称顺式阿曲库铵与罗库溴铵之间存在交叉反应。
