Anaphylaxis induced by hydroxyethyl starch during general anesthesia -A case report-.

Area of Science:

• Anesthesiology
• Pharmacology
• Critical Care Medicine

Background:

• Hydroxyethyl starch (HES) solutions are synthetic colloids used for hypovolemia treatment.
• While effective, HES solutions carry a risk of hypersensitivity reactions.
• Anaphylaxis is a severe allergic reaction that can be life-threatening.

Purpose of the Study:

• To report a case of anaphylaxis following Hydroxyethyl starch administration during surgery.
• To highlight the importance of recognizing and managing HES-induced anaphylaxis.
• To emphasize prompt management for successful surgical outcomes.

Main Methods:

• A 42-year-old male patient underwent aortic-iliac-femoral bypass surgery.
• Hydroxyethyl starch (HES) solution was administered for hypovolemia.
• Clinical signs of anaphylaxis (facial erythema, hypotension, bronchospasm) were observed minutes after HES infusion.
• HES administration was discontinued, and anaphylaxis was treated with medications.

Main Results:

• The patient developed immediate hypersensitivity symptoms consistent with anaphylaxis post-HES administration.
• Prompt medical intervention with vasopressors, antihistamines, and corticosteroids led to vital sign stabilization.
• The surgery was successfully completed without further complications after managing the allergic reaction.

Conclusions:

• Hydroxyethyl starch can precipitate anaphylactic reactions, even in patients without prior allergy history.
• Timely recognition and aggressive management of HES-induced anaphylaxis are crucial for patient safety.
• This case underscores the need for vigilance regarding potential adverse reactions to synthetic colloid solutions in surgical settings.