Medica Jadertina, Vol. 50 No. 2, 2020.
Professional paper
Severe allergic reactions following administration of Sugammadex with low tryptase levels but positive skin prick test: a case report
Tomislav Ružman
; The James Cook University Hospital, Middlesbrough; The Josip Juraj Strossmayer University of Osijek, Faculty of medicine, Osijek
Tatjana Šimurina
; The Josip Juraj Strossmayer University of Osijek, Faculty of medicine, Osijek; University of Zadar, Department of health studies; Zadar General hospital, Department of anesthesiology and intensive care
Boris Mraović
; University of Missoury - Columbia
Nataša Ružman
; North Tees University hospital, Stockton on Tees; The Josip Juraj Strossmayer University of Osijek, Faculty of medicine, Osijek
Abstract
We describe here the case of a severe anaphylactic episode to Sugammadex administered to reverse neuromuscular block in a 54-year-old man who underwent lumbar discectomy under general anaesthesia. Induction to anaesthesia and the entire surgical procedure were without any peculiarities. At the end of the surgery, 200 mg of Sugammadex was administered. Three minutes later, he developed a severe anaphylactic reaction accompanied by severe bronchospasm, with high peak airway pressures, drop of pulse oxygen saturation down to 70% despite FiO2 of 1.0, moderate decrease of arterial blood pressure (lowest was 80/50 mmHg) and normal heart rate of 70/min. Also, five minutes later he developed generalized skin rash and piloerection. The patient recovered completely after initial medical treatment per guidelines for treatment of anaphylactic shock. He was extubated in the Intensivel Care Unit a few hours later. Repeated blood mastocyte tryptase levels showed only a mild increase during the acute reaction. The allergic reaction to Sugammadex was confirmed by a positive intradermal test to Sugammadex a couple months later.
Keywords
anaesthesia; general, hypersensitivity; allergic reaction; anaphylaxis; Sugammadex
Hrčak ID:
242927
URI
Publication date:
24.8.2020.
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