60 https://www.id-press.eu/mjms/index
Scientifc Foundation SPIROSKI, Skopje, Republic of Macedonia
Open Access Macedonian Journal of Medical Sciences. 2020 May 11; 8(C):60-62.
https://doi.org/10.3889/oamjms.2020.3774
eISSN: 1857-9655
Category: C - Case Reports
Section: Case Report in Internal Medicine
Anaphylactic Shock Due to Atracurium in a Patient Underwent
General Anesthesia
Christopher Ryalino*, Otniel Adrians Labobar, Made Wiryana, I. Ketut Sinardja, Tjokorda Gde Agung Senapathi, Adinda Putra Pradhana
Department of Anesthesiology and Intensive Care, Faculty of Medicine, Udayana University, Bali, Indonesia
Abstract
BACKGROUND: Anaphylaxis is a systemic hypersensitivity reaction marked by life-threatening, rapid onset of the
airway, breathing, and circulation problems. Despite its rare incidence, without proper treatment, it may cause fatality.
CASE REPORT: In this report, we present a 19-year-old female with an infected ovarian cyst, who was scheduled for
gynecologic laparotomy. In pre-operative assessment, she was classifed as an American Society of Anesthesiologist
(ASA) one patient without any history of drug or food allergy. Hemodynamic changes occurred on anesthesia
induction after the administration ofatracurium, a muscle relaxant agent. Marked clinical signs were wheezed-
bronchospasm, dyspnea, hypersalivation, desaturation, tachycardia, hypotension, and systemic erythema. She was
diagnosed with anaphylactic shock. We provided 100% oxygenation, fuid resuscitation, epinephrine, and supportive
therapy by anaphylaxis guidelines. Respiratory and cardiovascular functions stabilized 2 h post-resuscitation. The
surgery was canceled, and she was observed in ICU for 24 h.
CONCLUSION: Timely diagnosis and early resuscitation are key factors determining the outcome of an anaphylactic
reaction.
Edited by: Ksenija Bogoeva-Kostovska
Citation: Ryalino C, Labobar OA, Wiryana M, Sinardja IK,
Senapathi TGA, Pradhana AP. Anaphylactic Shock Due to
Atracurium in a Patient Underwent General Anesthesia.
Open-Access Maced J Med Sci. 2020 May 11; 8(C):60-62.
https://doi.org/10.3889/oamjms.2020.3774
Keywords: Atracurium; Anaphylaxis; Perioperative; Epinephrine
*Correspondence: Christopher Ryalino, Department of
Anesthesiology and Intensive Care, Faculty of Medicine,
Udayana University, Jl. PB Sudirman, Denpasar 80232,
Bali, Indonesia. E-mail: ryalino@unud.ac.id
Received: 24-Sep-2019
Revised: 20-Jan-2020
Accepted: 28-Feb-2020
Copyright: © 2020 Christopher Ryalino,
Otniel Adrians Labobar, Made Wiryana, I. Ketut Sinardja,
Tjokorda Gde Agung Senapathi, Adinda Putra Pradhana
Funding: This research did not receive any fnancial support
Competing Interests: The authors have declared that no
competing interests exist
Open Access: This is an open-access article distributed
under the terms of the Creative Commons Attribution-
NonCommercial 4.0 International License (CC BY-NC 4.0)
Introduction
Anaphylaxis is a severe, life-threatening
systemic hypersensitivity reaction that is characterized
by the emergence of life-threatening airway, respiratory,
and circulatory problems with rapid onset and is usually
associated with changes in the skin and mucosa [1]. Its
prevalence ranges from 1:3,500 to 1:13,000 [2]. Overall,
anaphylaxis has a good prognosis, with a case fatality
ratio of <1%. The risk of death is increased in patients
with asthma, especially in uncontrolled asthma [3].
Anaphylactic reactions are generally
unpredictable allergic reactions, which occur very
quickly, which can arise especially during surgery
due to varying drug administration. The diagnosis of
anaphylaxis in the perioperative period is still a challenge
for the anesthesiologist. A study reported that of the 42
anesthesia teams tested by simulators, none was able
to identify anaphylaxis in the frst 10 min. [2], [4].
Case Illustration
A 19-year-old woman, 55 kg, was planned
for laparotomy surgery due to an infected left ovarian
cyst. A day before the surgery, detailed history, physical
examinations, and investigations were carried out. There
was no history of allergy to drugs or food, no history of
asthma, and no history of the previous surgery. There
were no marked abnormalities in physical or supporting
examinations.
She was planned for general anesthesia with
the insertion of the orotracheal tube. She received
cefotaxime 1 g and metronidazole 500 mg as
prophylactic antibiotics an hour before surgery and
was premedicated with dexamethasone 5 mg and
midazolam 2 mg. After induction with 75 mcg fentanyl
and 100 mg propofol intravenously, she still showed
stable hemodynamic conditions. To facilitate intubation,
we administered intravenous atracurium 25 mg.
One minute after the administration of atracurium,
we noticed hypersecretion in her airway. She then
developed wheezing sounds and difculty to ventilate
the airway. Saturation was decreased to 80% despite
100% O
2
being given, followed by marked erythema
developed in most parts of the skin, hypotension (BP
67/33 mmHg), and tachycardia (HR 134–138 bpm).
Anaphylaxis shock was diagnosed. We
immediately performed intubation to maintain the airway
– positive pressure ventilation with 100% FiO
2
oxygen.
Epinephrine 0.5 mg was given intramuscularly, and
dexamethasone 5 mg was administered intravenously.