Tripp Michael, Ribeiro Matthew, Kmiecik Susanna, Go Ramon
Department of Anesthesiology, Medstar Georgetown University Medical Center, Washington, DC, USA.
Case Rep Anesthesiol. 2021 Jun 24;2021:8859823. doi: 10.1155/2021/8859823. eCollection 2021.
Here, we present the case of a 54-year-old female presenting for outpatient ankle hardware removal who experienced severe total body pruritus along with a maculopapular rash persisting four days after the procedure. Patch testing demonstrated a sensitivity to benzyl alcohol, a preservative in propofol and several other anesthetics. The patient returned for left ankle arthroscopy a year later, and during that procedure, the anesthetic team avoided medications containing benzyl alcohol. This resulted in no pruritus or rash. Hypersensitivity reactions, ranging from contact dermatitis to anaphylaxis, are critical events in the perioperative period. Induction of general anesthesia has been implicated as the inciting event for perioperative hypersensitivity reactions. Benzyl alcohol is among a few excipients found in common anesthetic agents known to cause hypersensitivity reactions in susceptible patients. While reports of adult death are rare, infantile death due to benzyl alcohol has been described.
在此，我们报告一例54岁女性门诊行踝关节内固定取出术的病例，该患者术后出现严重的全身瘙痒以及斑丘疹皮疹，持续四天。斑贴试验显示对苯甲醇过敏，苯甲醇是丙泊酚及其他几种麻醉剂中的一种防腐剂。一年后患者再次行左踝关节镜检查，在该手术过程中，麻醉团队避免使用含苯甲醇的药物。结果未出现瘙痒或皮疹。超敏反应，从接触性皮炎到过敏反应，是围手术期的关键事件。全身麻醉诱导被认为是围手术期超敏反应的诱发事件。苯甲醇是常见麻醉剂中已知会在易感患者中引起超敏反应的少数辅料之一。虽然成人死亡报告罕见，但已有因苯甲醇导致婴儿死亡的描述。
