Masui. The Japanese journal of anesthesiology
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We report a case of anaphylactic shock induced by an antibiotic administrated after induction. A 39-year-old man was scheduled for removal of right adrenal tumor. After insertion of an epidural catheter, anesthesia was induced with an intravenous bolus injection of fentanyl 100 microg, propofol 130 mg and vecuronium 6 mg. ⋯ From his past history, penicillin allergy was confirmed. The surgery was rescheduled and anesthesia was managed in the same way as previous one. Surgery was successfully performed using levofloxacin, which had been taken orally before induction of anesthesia.
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A 76-year-old woman was scheduled to undergo distal gastrectomy and cholecystectomy. She had no history of illnesses including hypertension. During the induction of anesthesia, she developed hypertension just after intravenous administration of fentanyl 200 microg. ⋯ For the maintenance of anesthesia, sevoflurane, nitrous oxide, and epidural anesthesia with intermittent administration of 0.75% ropivacaine were used. The operation was finished successfully without any complications. We consider intravenous small dose of fentanyl could be a cause of unexpected marked hypertension in this elderly patient.