Korean J Anesthesiol.  2010 Oct;59(4):275-278. 10.4097/kjae.2010.59.4.275.

Recurrent unilateral lung ventilation disorder in a patient that experienced rocuronium-induced anaphylactic bronchospasm during laparoscopic rectal surgery: A case report

• Choi WJ
• Choi SI
• Mok JM
• Kim HS
• Kim YH

• KMID: 1766449
• DOI: http://doi.org/10.4097/kjae.2010.59.4.275

Abstract

Rocuronium is the anesthetic agent most likely to cause anaphylaxis. Immediately after intravenous rocuronium administration, the authors experienced ventilatory impairment due to unilateral bronchospasm (left lung), which was relieved by emergency treatment. However, 80 minutes after beginning laparoscopic surgery for rectal cancer, the left lung suddenly re-collapsed under pneumoperitoneum in the Trendelenburg position. A postoperative intradermal test revealed that rocuronium, vecuronium, atracurium, succinylcholine, or thiopental could induce anaphylaxis in this patient, but it was not established whether the second incident during surgery was due to endobronchial intubation or anaphylactic bronchospasm. This case cautions that under pneumoperitoneum in the Trendelenburg position, patients suspected of being prone to anaphylactic bronchospasm should also be considered at risk of endobronchial intubation.

Keyword

Anaphylaxis; Bronchial spasm; Laparoscopic surgery; Rocuronium

MeSH Terms

Anaphylaxis
Androstanols
Atracurium
Bronchial Spasm
Emergency Treatment
Head-Down Tilt
Humans
Intradermal Tests
Intubation
Laparoscopy
Lung
Pneumoperitoneum
Rectal Neoplasms
Succinylcholine
Thiopental
Vecuronium Bromide
Ventilation
Androstanols
Atracurium
Succinylcholine
Thiopental
Vecuronium Bromide