| Anesthetic Management in a Patient with Cross-Sensitivity to Muscle Relaxants: A case report. |
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Mi Suk Koo, Chul Woo Jung |
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Department of Anesthesiology, Seoul National University College of Medicine, Seoul, Korea. spss@dreamwiz.com |
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| Abstract |
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Anaphylactic reactions to muscle relaxants have been increasingly reported during recent 30 years. An adequate investigation of patient's history and avoidance of the muscle relaxant responsible for the previous reaction would reduce the risk of second reaction. A 56-year-old woman was admitted for laparoscopic cholecystectomy. She had a history of serious anaphylactic reaction to vecuronium. Preoperative intradermal skin test against muscle relaxants showed positive reactions to succinylcholine, atracurium and rocuronium. General anesthesia was induced with midazolam, fentanyl, 8 vol% sevoflurane mixed with 50% oxygen.
Laryngeal mask airway was inserted without muscle relaxant and anesthesia was maintained with 4-6 vol% sevoflurane, air and oxygen without muscle relaxant. The anesthesia and postoperative course of this patient were uneventful. |
| Key Words:
anaphylaxis; cross sensitivity; laparoscopic surgery; muscle relaxant |
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