title: [A Case of Rocuronium Anaphylaxis in which Anesthesia was Safely Performed after Selection of an Alternative Drug after a Skin Test].
abstract: We report our experience of a patient with a history of anaphylactic shock suspected to be caused by rocuronium who was scheduled to undergo hepatic tumor resection. The patient was a 17-year-old female (height : 166 cm, weight : 46 kg). During general anesthesia at another hospital several years ago, she had an anaphylactic shock, and rocuronium was suspected to be the offending drug. To collect information and search for the cause, skin tests were performed for rocuronium, vecuronium and suxamethonium. She was positive for rocuronium, and negative for other drugs. At anesthesia induction, we administered vecuronium and confirmed no development of anaphylaxis before commencement of surgery. In the perioperative period, she had no symptoms that indicated anaphylaxis. Since there is potential high cross-reactivity among muscle relaxants, it is important to perform a test for alternative drugs when a muscle relaxant may be a cause of anaphylaxis. Selection and administration of an alternative drug should be carefully performed, even when a skin test is negative for the alternative drug.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Naruse
authors.forename: Hiroki
authors.initials: H
authors.lastname: Iwata
authors.forename: Kota
authors.initials: K
authors.lastname: Suzuki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Uraoka
authors.forename: Takasumi
authors.initials: T
authors.lastname: Katoh
authors.forename: Shigehito
authors.initials: S
authors.lastname: Sato
mesh_terms: D000293:Adolescent; D000707:Anaphylaxis / Q000139:chemically induced*; D000732:Androstanols / Q000009:adverse effects*; D000768:Anesthesia, General; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery; D059035:Perioperative Period; D000077123:Rocuronium; D012882:Skin Tests; D016896:Treatment Outcome; D014673:Vecuronium Bromide / Q000627:therapeutic use*
chemical_list: D000732:Androstanols; D014673:Vecuronium Bromide; D000077123:Rocuronium