Anesth Pain Med.  2015 Jul;10(3):187-191. 10.17085/apm.2015.10.3.187.

Anaphylaxis to topical bovine thrombin used for hemostasis during surgery for herniated nucleus pulposus: A case report

• Kim H
• Lee D
• Lee H
• Han J

• KMID: 2148029
• DOI: http://doi.org/10.17085/apm.2015.10.3.187

Abstract

Anaphylaxis is a type I allergic reaction and its clinical features occur after re-exposure to the same allergen. Numerous types of drugs can cause anaphylaxis during general anesthesia. Topical bovine thrombin (TBT) is usually used for hemostasis during surgery. However, TBT can cause interruption of the normal blood coagulation pathways, delay wound repair, and lead to uncontrolled bleeding, anaphylaxis, or death. Anaphylaxis caused by TBT during the perioperative period is very rare. We report the case of a patient who developed severe hypotension, tachycardia, and bronchospasm while undergoing discectomy for herniated nucleus pulposus. Based on the symptoms and signs, anaphylaxis was considered most likely. Identification of the causative agents is important in these cases because it can be very helpful for the management and prevention of anaphylaxis.

Keyword

Anaphylaxis; Epinephrine; Topical bovine thrombin

MeSH Terms

Anaphylaxis*
Anesthesia, General
Blood Coagulation
Bronchial Spasm
Diskectomy
Epinephrine
Hemorrhage
Hemostasis*
Humans
Hypersensitivity
Hypotension
Perioperative Period
Tachycardia
Thrombin*
Wounds and Injuries
Epinephrine
Thrombin