Soonchunhyang Med Sci.  2019 Jun;25(1):76-79. 10.0000/sms.2019.25.1.76.

Severe Anaphylaxis without Key Signs Such as Urticaria and Bronchospasm Suspected to Be Induced by Rocuronium

• Kim AJ
• Chun HR

• KMID: 2452802
• DOI: http://doi.org/10.0000/sms.2019.25.1.76

Abstract

Perioperative hypersensitivity reaction have been reported to have a variable degree of the incidence from differ countries and to be 1/353-18,600 approximately and its mortality has been reported to be 4%-4.76% in the United States and Japan, respectively. A 65-year-old male patient with hypertension, rheumatoid arthritis, and history of amoxicillin allergy was scheduled for laparoscopic radical prostatectomy due to prostate cancer. Lidocaine, propofol, and rocuronium were administered sequentially to induce general anesthesia. Twenty minutes after the rocuronium administration, severe hypotension and tachycardia developed. But key signs of hypersensitivity such as urticaria and bronchospasm were not appeared. The operation was canceled and we evaluated the cause of severe hypotension and could confirm hypersensitivity for rocuronium with intradermal test after 4 weeks.

Keyword

Anaphylaxis; Intradermal tests; Rocuronium; Urticaria

MeSH Terms

Aged
Amoxicillin
Anaphylaxis*
Anesthesia, General
Arthritis, Rheumatoid
Bronchial Spasm*
Humans
Hypersensitivity
Hypertension
Hypotension
Incidence
Intradermal Tests
Japan
Lidocaine
Male
Mortality
Propofol
Prostatectomy
Prostatic Neoplasms
Tachycardia
United States
Urticaria*
Amoxicillin
Lidocaine
Propofol