Nakao M, Nakatani K, Suyama H, Maekawa T, Nakagawa M, Hanaki C, Kawaguchi R
Division of Anesthesia and Critical Care, Hiroshima Prefectural Hospital.
Masui. 1997 Jan;46(1):105-9.
A 64 year-old man developed life-threatening anaphylactoid reaction caused by povidone-iodine during induction of anesthesia for elective coronary artery bypass graft surgery. While he had a history of cardiac arrest caused by iodine, he could tolerate contrast material and povidone-iodine for pre-operative coronary angiography with pretreatment of H1 and H2 receptor blockades and methylprednisolone. During the operation and postoperative care we could manage cardiac failure by continuous monitoring of cardiac output (CCO) using pulsed-thermodilution method. We recommend prophylactic use of H1 and H2 receptor blockades for surgical patients who may be at risk for anaphylaxis or anaphylactoid reaction.
一名64岁男性在择期冠状动脉搭桥手术麻醉诱导期间发生了由聚维酮碘引起的危及生命的类过敏反应。虽然他有碘导致心脏骤停的病史,但在使用H1和H2受体阻滞剂及甲泼尼龙预处理的情况下,他能够耐受术前冠状动脉造影所用的造影剂和聚维酮碘。在手术及术后护理过程中,我们通过使用脉冲热稀释法持续监测心输出量(CCO)来处理心力衰竭。我们建议对可能有过敏或类过敏反应风险的手术患者预防性使用H1和H2受体阻滞剂。