DOI QR코드

DOI QR Code

Anaphylaxis occurred immediately after prophylactic antibiotics injection with negative intradermal skin test during laparoscopic cholecystectomy

  • Jeong, Hyung Joo (Department of Anesthesiology and Pain Medicine, College of Medicine, Kosin University) ;
  • Kung, Hsi Chiang (Department of Anesthesiology and Pain Medicine, College of Medicine, Kosin University) ;
  • Park, Tae Woo (Department of Anesthesiology and Pain Medicine, College of Medicine, Kosin University) ;
  • Kang, Dong Hee (Department of Anesthesiology and Pain Medicine, College of Medicine, Kosin University) ;
  • Shin, Yu Som (Department of Anesthesiology and Pain Medicine, College of Medicine, Kosin University) ;
  • Kim, Ju Deok (Department of Anesthesiology and Pain Medicine, College of Medicine, Kosin University)
  • Received : 2017.08.04
  • Accepted : 2017.08.28
  • Published : 2018.12.31

Abstract

Prophylactic antibiotics that are used to prevent post-operative infection can commonly cause anaphylactic reactions during anesthesia. It is therefore necessary to perform a skin test before antibiotics are administered in order to diagnose and prevent anaphylactic reactions. However, the results of the antibiotic skin test can differ according to the drug, dose, and reagent concentration. We report a case of anaphylactic shock with bronchospasm and cardiovascular collapse immediately following administration of the prophylactic cefazedone after induction of general anesthesia for laparoscopic cholecystectomy.

Keywords

References

  1. Dewachter P, Mouton-Faivre C, Emala CW. Anaphylaxis and anesthesia: controversies and new insights. Anesthesiology 2009;111:1141-50. https://doi.org/10.1097/ALN.0b013e3181bbd443
  2. Kroigaard M, Garvey LH, Gillberg L, Johansson SG, Mosbech H, Florvaag E, et al. Scandinavian Clinical Practice Guidelines on the diagnosis, management and follow-up of anaphylaxis during anaesthesia. Acta Anaesthesiol Scand 2007;51:655-70. https://doi.org/10.1111/j.1399-6576.2007.01313.x
  3. Torres MJ, Romano A, Mayorga C, Moya MC, Guzman AE, Reche M, et al. Diagnostic evaluation of a large group of patients with immediate allergy to penicillins: the role of skin testing. Allergy 2001;56:850-6. https://doi.org/10.1034/j.1398-9995.2001.00089.x
  4. Brockow K, Romano A, Blanca M, Ring J, Pichler W, Demoly P. General considerations for skin test procedures in the diagnosis of drug hypersensitivity. Allergy 2002;57:45-51.
  5. Classen DC, Evans RS, Pestotnik SL, Horn SD, Menlove RL, Burke JP. The timing of prophylactic administration of antibiotics and the risk of surgical-wound infection. N Engl J Med 1992;326:281-6. https://doi.org/10.1056/NEJM199201303260501
  6. Harper NJ, Dixon T, Dugue P, Edgar DM, Fay A, Gooi HC, et al. Suspected anaphylactic reactions associated with anaesthesia. Anaesthesia 2009;64:199-211. https://doi.org/10.1111/j.1365-2044.2008.05733.x
  7. Park JE, Hwang SY, Lee YS, Lee HK, Lee YM. Analysis on Results of Cephalosporin Skin Testing and Developments of Hypersensitivity Reactions. J Kor Soc Health-Syst Pharm 2013;30:343-61.
  8. Kim KN, Kim DW, Sin YH, Oh SY. Anaphylactic shock caused by an intradermal skin test-negative antibiotic during general anesthesia : A case report. Anesth Pain Med 2016;11:260-3. https://doi.org/10.17085/apm.2016.11.3.260
  9. Trautmann A, Seidl C, Stoevesandt J, Seitz CS. General anaesthesia-induced anaphylaxis: impact of allergy testing on subsequent anaesthesia. Clin Exp Allergy 2016;46:125-32. https://doi.org/10.1111/cea.12632
  10. Moreno E, Macias E, Davila I, Laffond E, Ruiz A, Lorente F. Hypersensitivity reactions to cephalosporins. Expert Opin Drug Saf 2008;7:295-304. https://doi.org/10.1517/14740338.7.3.295
  11. Torres MJ, Blanca M, Fernandez J, Romano A, Weck A, Aberer W, et al. Diagnosis of immediate allergic reactions to beta-lactam antibiotics. Allergy 2003;58:961-72. https://doi.org/10.1034/j.1398-9995.2003.00280.x
  12. Ebo DG, Fisher MM, Hagendorens MM, Bridts CH, Stevens WJ. Anaphylaxis during anaesthesia: diagnostic approach. Allergy 2007;62:471-87. https://doi.org/10.1111/j.1398-9995.2007.01347.x
  13. Mertes PM, Malinovsky JM, Jouffroy L, Aberer W, Terreehorst I, Brockow K, et al. Reducing the risk of anaphylaxis during anesthesia: 2011 updated guidelines for clinical practice. J Investig Allergol Clin Immunol 2011;21:442-53.
  14. Woods BD, Sladen RN. Perioperative considerations for the patient with asthma and bronchospasm. Br J Anaesth 2009;103:i57-65. https://doi.org/10.1093/bja/aep271
  15. Dewachter P, Mouton-Faivre C, Emala CW, Beloucif S. Case scenario: bronchospasm during anesthetic induction. Anesthesiology 2011;114:1200-10. https://doi.org/10.1097/ALN.0b013e3182172cd3