rocuronium and Bronchial-Spasm

We report a grade III allergic hypersensitivity reaction occurring in a 72-year-old patient immediately after anaesthesia induction. Anaphylaxis to cisatracurium was diagnosed on clinical symptoms, biological tests and positivity of the cutaneous tests to this neuromuscular blocking agent. Five days after this allergological assessment, rocuronium, a muscle relaxant for which skin tests appeared negative was used during surgery without adverse effects. The authors underline the value of a detailed allergological assessment to identify the pathophysiologic mechanism, the culprit drug and to propose a safer alternate drug that might be used.

Topics: Adenocarcinoma; Aged; Anaphylaxis; Androstanols; Atracurium; Bronchial Spasm; Drug Hypersensitivity; Humans; Intraoperative Complications; Male; Neuromuscular Nondepolarizing Agents; Rectal Neoplasms; Rocuronium; Sigmoid Neoplasms; Skin Tests

Topics: Bronchial Spasm; gamma-Cyclodextrins; Humans; Neuromuscular Blockade; Rocuronium; Sugammadex

Topics: Anaphylaxis; Anesthesia; Bronchial Spasm; Desflurane; Humans; Rocuronium; Sugammadex

Topics: Anaphylaxis; Anesthesia; Anesthetics, Inhalation; Bronchial Spasm; Desflurane; Humans; Isoflurane; Rocuronium; Sugammadex

Muscle relaxant drugs are the most frequent cause of anaphylactic and anaphylactoid reactions during anaesthesia. We report a case of a life-threatening anaphylactic reaction during induction of anaesthesia with severe bronchospasm as the first clinical symptom. Mechanical ventilation was nearly impossible. The patient required a multimodal antiallergic therapy and a high-dose catecholamine therapy for stabilization. Rocuronium was identified as the allergic agent using intradermal testing.

Topics: Anaphylaxis; Androstanols; Anesthesia; Bronchial Spasm; Catecholamines; Humans; Male; Middle Aged; Neuromuscular Nondepolarizing Agents; Respiration, Artificial; Rocuronium; Skin; Skin Tests

Topics: Abdominal Pain; Adolescent; Anaphylaxis; Androstanols; Antibodies; Bronchial Spasm; Chymases; Drug Hypersensitivity; Edema; Female; Follow-Up Studies; Humans; Immunoglobulin E; Inflammation Mediators; Laparoscopy; Neuromuscular Blockade; Neuromuscular Nondepolarizing Agents; Rocuronium; Serine Endopeptidases; Skin Tests; Tryptases; Urticaria