• Anaesth Intensive Care · Nov 2012

    Case Reports

    Failure to investigate anaesthetic anaphylaxis resulting in a preventable second anaphylactic reaction.

    • A F Pedersen, S Green, and M A Rose.
    • Department of Anaesthesia, Royal North Shore Hospital, Sydney, New South Wales, Australia.
    • Anaesth Intensive Care. 2012 Nov 1; 40 (6): 105310551053-5.

    AbstractWe present a case of anaphylaxis to suxamethonium and/or vecuronium in a patient who had previously suffered an anaphylactic reaction, presumably to rocuronium. The patient had not been referred for formal allergy testing after the first anaphylactic reaction. Subsequent formal allergy testing revealed sensitivities to suxamethonium, rocuronium and vecuronium. Her next anaesthetic, using cisatracurium, was uneventful. It is recommended that all patients with suspected perioperative anaphylaxis are referred for testing. This is the responsibility of the anaesthetist. Particular caution should be used with suspected neuromuscular blocking drug allergy as cross-reactivity is common and not predictable by drug structure.

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    This article appears in the collection: What is the significance of Pholcodine for anesthesia?.

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    Patient was IgE positive to both morphine & pholcodine...

    Daniel Jolley  Daniel Jolley
     
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