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Related Experiment Videos

Anaphylaxis to intrathecal diamorphine.

Ingrid Gooch1, Carl Gwinnutt

  • 1Department of Anaesthesia, Hope Hospital, Stott Lane, Salford M6 8HD, UK.

Resuscitation
|August 12, 2006
PubMed
Summary

This case report details a rare instance of anaphylaxis caused by intrathecal diamorphine during hip surgery. Prompt treatment with adrenaline led to a full recovery, highlighting the need to consider this opioid in allergic reactions.

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Area of Science:

  • Anesthesiology
  • Clinical Immunology

Background:

  • Subarachnoid anesthesia using intrathecal bupivacaine and diamorphine is common for total hip arthroplasty.
  • Adverse reactions to spinal anesthesia can mimic side effects of anesthetic agents, complicating diagnosis.

Observation:

  • A 42-year-old male experienced an allergic reaction during surgery, initially mistaken for known side effects of intrathecal diamorphine.
  • Serum mast cell tryptase levels confirmed anaphylaxis approximately 1.5 hours post-incident.

Findings:

  • Skin prick testing identified diamorphine as the probable cause of the anaphylactic reaction.
  • This is believed to be the first reported case of intrathecal diamorphine-induced anaphylaxis.

Implications:

  • Anesthesiologists should consider diamorphine as a potential allergen in patients presenting with anaphylaxis during spinal anesthesia.
  • Early recognition and management with adrenaline are crucial for favorable outcomes in diamorphine-induced anaphylaxis.

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