Red Man's syndrome following administration of vancomycin in a patient under spinal anesthesia--a case report.
Prophylactic antibiotics are frequently administered during anesthesia to reduce the incidence of infection. The most common organisms revealed in wound infections are staphylococci. Vancomycin is the antibiotic of choice for resistant staphylococcal infections and bacterial endocarditis in patient allergic to penicillin. We had a case of tibial osteomyelitis, while undergoing removal of implants under spinal anesthesia developed hypotensions, bradycardia, consciousness change and skin erythematous macular rash after 0.1% vancomycin slow infusion for 10 min. After appropriate management, the patient recovered well and was discharged on the following day. Our report is intended to alert our colleagues that vancomycin can cause hypotension secondary to histamine release, direct myocardial depression and direct peripheral vasodilation. Even cardiac arrest had been reported in the literatures.
Hui
Yu-Ling
YL
Department of Anesthesia, Chang Gung Memorial Hospital at Keeling, 222, Mai-Chin Road, Keeling, Taiwan, R.O.C. ylhui@adm.cgmh.org.tw
Yu
Chun-Cheung
CC
Ng
Yuet-Tong
YT
Lau
Wai-Meng
WM
Hsieh
Jing-Ru
JR
Chung
Peter Chi-Ho
PC
D000775:Anesthesia, Spinal; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D019072:Antibiotic Prophylaxis; D003875:Drug Eruptions / Q000209:etiology*; D006636:Histamine Release / Q000187:drug effects; D006801:Humans; D007022:Hypotension / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D014640:Vancomycin / Q000009:adverse effects*
D000900:Anti-Bacterial Agents; D014640:Vancomycin