Recurrent unilateral lung ventilation disorder in a patient that experienced rocuronium-induced anaphylactic bronchospasm during laparoscopic rectal surgery -A case report-.
Rocuronium is the anesthetic agent most likely to cause anaphylaxis. Immediately after intravenous rocuronium administration, the authors experienced ventilatory impairment due to unilateral bronchospasm (left lung), which was relieved by emergency treatment. However, 80 minutes after beginning laparoscopic surgery for rectal cancer, the left lung suddenly re-collapsed under pneumoperitoneum in the Trendelenburg position. A postoperative intradermal test revealed that rocuronium, vecuronium, atracurium, succinylcholine, or thiopental could induce anaphylaxis in this patient, but it was not established whether the second incident during surgery was due to endobronchial intubation or anaphylactic bronchospasm. This case cautions that under pneumoperitoneum in the Trendelenburg position, patients suspected of being prone to anaphylactic bronchospasm should also be considered at risk of endobronchial intubation.
Department of Anesthesiology and Pain Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Won Joon
WJ
Choi
Soo Il
SI
Choi
Jeong Min
JM
Mok
Hyun Soo
HS
Kim
Yun Hong
YH
Kim