Reed Heather, Shaw Christiana, Rice Mark, Le Huong Thi
From the Departments of *Anesthesiology, and †Surgery, University of Florida, Gainesville, Florida.
A A Case Rep. 2014 Jul 1;3(1):1-2. doi: 10.1213/XAA.0000000000000036.
A 44-year-old woman presented for sentinel node biopsy and segmental mastectomy. After anesthetic induction, a laryngeal mask airway was placed, and ventilation was satisfactory. Three minutes after isosulfan blue dye injection, ventilation became difficult. The laryngeal mask airway was removed, and an endotracheal tube was easily placed. Twenty minutes later, she became hypotensive and unresponsive to phenylephrine, ephedrine, and vasopressin. With erythema and swelling in her arm and chest, low-dose epinephrine was titrated until her mean arterial blood pressure stabilized. Serum tryptase was increased to 27.2 μg/L (normal 0.4-10.9 μg/L).
一名44岁女性因前哨淋巴结活检及乳房部分切除术前来就诊。麻醉诱导后，置入喉罩气道，通气良好。注射异硫蓝染料三分钟后，通气变得困难。移除喉罩气道，轻松置入气管导管。二十分钟后，她出现低血压，对去氧肾上腺素、麻黄碱和血管加压素无反应。其手臂和胸部出现红斑和肿胀，滴定小剂量肾上腺素直至其平均动脉血压稳定。血清类胰蛋白酶升高至27.2μg/L（正常范围0.4 - 10.9μg/L）。
