Department of Anesthesiology and Pain Medicine, Korea University College of Medicine, Ansan Hospital, Ansan, Korea.
Korean J Anesthesiol. 2010 Apr;58(4):391-5. doi: 10.4097/kjae.2010.58.4.391. Epub 2010 Apr 26.
Perioperative anaphylaxis is characterized by severe respiratory and cardiovascular manifestations. Correct management of anaphylaxis during anaesthesia requires a multidisciplinary approach with prompt recognition and treatment of the acute event by the attending anesthesiologist. A 34-year-old woman was scheduled to undergo endo venous laser therapy of varicose veins. She had no history of allergies and had never undergone general anesthesia. General anesthesia was induced with propofol and rocuronium bromide. Approximately three minutes after rocuronium administration, hypotension and tachycardia developed and angioedema around the eyelids and skin rashes and urticaria appeared. The patient received ephedrine and hydrocortisone with hydration. After achieving stable vital signs and symptom relief, surgery was performed without complications. A postoperative skin dermal test performed to identify the agent responsible revealed a positive skin test for rocuronium.
围手术期过敏反应的特征为严重的呼吸和心血管表现。麻醉期间过敏反应的正确处理需要多学科方法，麻醉医生应及时识别并治疗急性事件。一位 34 岁女性拟行静脉内激光治疗静脉曲张。她无过敏史，从未行全身麻醉。采用丙泊酚和罗库溴铵诱导全身麻醉。罗库溴铵给药后约 3 分钟，出现低血压和心动过速，出现眼睑周围血管性水肿和皮疹、荨麻疹。患者接受麻黄碱和氢化可的松补液治疗。生命体征稳定且症状缓解后，手术顺利进行，无并发症。为明确致敏药物，进行术后皮肤皮内试验，结果显示罗库溴铵皮试阳性。
