Anesth Pain Med.  2019 Oct;14(4):412-415. 10.17085/apm.2019.14.4.412.

Anaphylactic reaction with hydroxyethyl starch during anesthesia: A case report

• Kim G
• Kim G
• Kwon M
• Koo M
• Yun M

• KMID: 2465338
• DOI: http://doi.org/10.17085/apm.2019.14.4.412

Abstract

BACKGROUND
Hydroxyethyl starch (HES), a class of synthetic colloid solutions, has been widely used to treat perioperative hypovolemia. The use of HES, however, is associated with the risk of allergic reactions. CASE: An 83-year-old man was scheduled to undergo an open reduction and internal fixation of a pertrochanteric fracture under spinal anesthesia. He had no history of allergy. Five minutes after HES administration, hypotension, agitation, and skin rash were developed. HES infusion was terminated due to a suspected anaphylactic reaction. The vital signs recovered following administration of phenylephrine, dexamethasone, and hydrocortisone. Serum tryptase and total immunoglobulin E levels were elevated in plasma samples collected following the commencement of the allergic reaction during surgery.
CONCLUSIONS
In the present report, the risk of anaphylactic reaction with HES and the laboratory tests needed to support the diagnosis are highlighted.

Keyword

Anaphylaxis; Anesthesia, Spinal; Starch

MeSH Terms

Aged, 80 and over
Anaphylaxis*
Anesthesia*
Anesthesia, Spinal
Colloids
Dexamethasone
Diagnosis
Dihydroergotamine
Exanthema
Humans
Hydrocortisone
Hypersensitivity
Hypotension
Hypovolemia
Immunoglobulin E
Immunoglobulins
Phenylephrine
Plasma
Starch*
Tryptases
Vital Signs
Colloids
Dexamethasone
Dihydroergotamine
Hydrocortisone
Immunoglobulin E
Immunoglobulins
Phenylephrine
Starch
Tryptases

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