Anaphylactic reaction after fluorescein sodium administration during intracranial surgery.
We present a male patient who underwent a fluorescein sodium-guided brain tumor excision and experienced an anaphylactic reaction with severe hypotension and bradycardia. A 54-year-old, 70 kg man of American Society of Anesthesiologists status II was seen with a history of glioma. In the 80th minute of the operation, 20 mg/kg intravenous (i.v.) fluorescein sodium was injected after dural opening. A few minutes later, the anaphylactic reaction was diagnosed. Surgery was ended and the patient was delivered to the intensive care unit with intubation. Laboratory values were: immunoglobulin E, 332 U (upper limit 100 U); and elevated tryptase, 3.12 mg/dL. In view of the expanding use of fluorescein sodium in clinical procedures, physicians should be alerted to this rare but life-threatening adverse event.
Department of Anesthesia and Reanimation, Faculty of Medicine, Kocaeli University, AD 41100 Umuttepe, Kocaeli, Turkey. dilekozdamar@gmail.com
Ozdamar
O
Dilek
Anik
A
Ihsan
Hosten
H
Tulay
D000707:Anaphylaxis / Q000139:chemically induced*; D001932:Brain Neoplasms / Q000601:surgery; D019793:Fluorescein / Q000009:adverse effects*; D005456:Fluorescent Dyes / Q000009:adverse effects*; D005910:Glioma / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures
D005456:Fluorescent Dyes; D019793:Fluorescein