Anesth Pain Med.  2016 Oct;11(4):384-388. 10.17085/apm.2016.11.4.384.

Consecutive anaphylaxis due to rocuronium and cisatracurium during general anesthesia: A case report

• Lee CH
• Lim BG
• Cho SI
• Lee SH
• Mun SH
• Lee IO

• KMID: 2358336
• DOI: http://doi.org/10.17085/apm.2016.11.4.384

Abstract

We experienced anaphylaxis during general anesthesia twice in the same patient. After the first incidence of anaphylaxis at the induction of anesthesia, we speculated that the allergen was rocuronium. Thus, we administered sugammadex as well as a vasopressor to treat the anaphylaxis and the vital signs gradually recovered to nearly normal. Thereafter, we could not avoid the administration of another muscle relaxant, cisatracurium, since the patient moved uncontrollably after the surgery was restarted. A second anaphylactic event then occurred. We speculated that the second allergen was cisatracurium and stopped using it. The results of the investigation after the surgery showed that the allergens were indeed rocuronium and cisatracurium. When we encounter anaphylaxis during general anesthesia, it is necessary to suspect all administered medicines as the cause, with the potential of two or more causes, especially with muscle relaxants.

Keyword

Anaphylaxis; Cisatracurium; General anesthesia; Intradermal test; Rocuronium

MeSH Terms

Allergens
Anaphylaxis*
Anesthesia
Anesthesia, General*
Humans
Incidence
Intradermal Tests
Vital Signs
Allergens

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