Abstract

COSIMINI, Leonel Ezequiel Amoroso  and  FERRARI ACOSTA, María Gabriela. Anafilaxia y anestesia. Anest Analg Reanim [online]. 2013, vol.26, n.1, pp.7-7. ISSN 1688-1273.

SUMMARY          Objective: to present two clinical cases of patients who had a severe anaphylactic reaction during anesthesia with a different clinical evolution. Case 1: female, 19 years of age, with scheduled surgery for thyroglossal cyst removal. No history of allergy. During induction of anesthesia she presented tachycardia and severe hypotension, with skin exanthema. Treatment administered: intravenous, Adrenaline, Hydrocortisone, Chlorpheniramine and crystalloids, which resulted in a rapid restoration of the hemodynamic stability and the subsequent suspension of the procedure. Postoperative period: atracurium-positive skin test. Case 2: female, 57 years of age, with scheduled surgery for aortic valve replacement due to symptomatic severe stenosis. During anesthetic induction for cesarean section 25 years ago the patient developed serious anaphylactic reaction with cardiorespiratory arrest. Cardiac catheterization 1 month ago with no incidents, oral corticosteroids were administered 3 days before. Oral corticosteroids and antihistamines were administered the night before valve replacement. Allergic to dipyrone, aspirin, ampicillin, cephradine, iodine and "anesthetic drugs". During induction of anesthesia she developed anaphylactic shock with severe refractory hypotension despite resuscitation attempts and died in the operating room. Discussion: incidence of anaphylactic reactions varies from 1/3.500 to 1/20.000 anesthesias, with a perioperative mortality rate between 3 and 10%; around 90% happens during induction of anesthesia. Muscle Relaxants are the mostly involved. Specific and early management in each stage improves the outcomes. The only effective measure to prevent anaphylactic reactions is to avoid contact with the responsible agent. Conclusions: clinical cases are presented in which the preparation and treatment had an effect on patients progress

Keywords : ANAPHYLACTIC REACTION; ANESTHESIA; ALLERGY; ANAPHYLACTIC SHOCK; HYPERSENSITIVITY.

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