title: [Dextran-induced anaphylactic shock during general anesthesia: a case report].
abstract: We describe a case of dextran-induced anaphylactic shock during general anesthesia. A 34-year-old woman was scheduled for partial hepatic resection under general anesthesia. General anesthesia was induced with intravenous remifentanil, thiamylal and rocuronium, and was maintained with oxygen, air, sevoflurane and remifentanil. The patient developed hypotension (from 90/50 to 49/27 mmHg in 20 min) together with tachycardia (111 beats x min(-1)) and desaturation (83%) subsequent to intravenous infusion of Saviosol (dextran 40). We made a diagnosis of anaphylactic shock on the basis of clinical manifestations and administered adrenaline and hydrocortisone. The patient's blood pressure and oxygen saturation immediately improved, and the operation was resumed. No postoperative complications were evident, and the postoperative course was uneventful. Although low molecular weight dextran is often used as plasma expander or to prevent thromboembolism, it can cause severe hypotension or bronchospasm during general anesthesia.
authors.affiliation: Department of Anesthesiology and Clinical Research, National Hospital Organization Zentsuji Hospital, Zentsuji 765-8507.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kawano
authors.forename: Kayo
authors.initials: K
authors.lastname: Nomura
authors.forename: Shinji
authors.initials: S
authors.lastname: Kawahito
authors.forename: Naohiro
authors.initials: N
authors.lastname: Ohshita
authors.forename: Katsuya
authors.initials: K
authors.lastname: Tanaka
authors.forename: Shuzo
authors.initials: S
authors.lastname: Oshita
mesh_terms: D000328:Adult; D000707:Anaphylaxis / Q000139:chemically induced*; D000768:Anesthesia, General; D003911:Dextrans / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D010952:Plasma Substitutes / Q000009:adverse effects*
chemical_list: D003911:Dextrans; D010952:Plasma Substitutes