Korean J Anesthesiol.  2006 Jan;50(1):90-93. 10.4097/kjae.2006.50.1.90.

Anesthetic Management in a Patient with Cross-Sensitivity to Muscle Relaxants: A case report

• Koo MS
• Jung CW

• KMID: 2237483
• DOI: http://doi.org/10.4097/kjae.2006.50.1.90

Abstract

Anaphylactic reactions to muscle relaxants have been increasingly reported during recent 30 years. An adequate investigation of patient's history and avoidance of the muscle relaxant responsible for the previous reaction would reduce the risk of second reaction. A 56-year-old woman was admitted for laparoscopic cholecystectomy. She had a history of serious anaphylactic reaction to vecuronium. Preoperative intradermal skin test against muscle relaxants showed positive reactions to succinylcholine, atracurium and rocuronium. General anesthesia was induced with midazolam, fentanyl, 8 vol% sevoflurane mixed with 50% oxygen. Laryngeal mask airway was inserted without muscle relaxant and anesthesia was maintained with 4-6 vol% sevoflurane, air and oxygen without muscle relaxant. The anesthesia and postoperative course of this patient were uneventful.

Keyword

anaphylaxis; cross sensitivity; laparoscopic surgery; muscle relaxant

MeSH Terms

Anaphylaxis
Anesthesia
Anesthesia, General
Atracurium
Cholecystectomy, Laparoscopic
Female
Fentanyl
Humans
Laparoscopy
Laryngeal Masks
Midazolam
Middle Aged
Oxygen
Skin Tests
Succinylcholine
Vecuronium Bromide
Atracurium
Fentanyl
Midazolam
Oxygen
Succinylcholine
Vecuronium Bromide