Anaphylactoid or carcinoid?
A patient with a carcinoid tumour and a history suggestive of carcinoid syndrome, but with no biochemical evidence in support, had a cardiovascular collapse during an anaesthetic with propofol and suxamethonium. Subsequent investigations suggested an anaphylactoid reaction to suxamethonium, but there were features in common with a carcinoid crisis. The necessity for a second anaesthetic soon afterwards posed a dilemma. In the event of a similar reaction during another anaesthetic, a management plan beforehand should include ready availability of appropriate drugs and the use of sympathomimetic drugs that are less likely to exacerbate the situation.
Batchelor
A M
AM
Department of Anaesthesia, Freeman Hospital, Newcastle upon Tyne.
Conacher
I D
ID
D000208:Acute Disease; D000328:Adult; D000707:Anaphylaxis / Q000150:complications*; D005260:Female; D006801:Humans; D007022:Hypotension / Q000209:etiology*; D007431:Intraoperative Complications / Q000209:etiology*; D008303:Malignant Carcinoid Syndrome / Q000150:complications*; D013390:Succinylcholine / Q000009:adverse effects*
D013390:Succinylcholine