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Published on: October 14, 2014
[Dextran-induced anaphylactic shock during general anesthesia: a case report].
Hiroaki Kawano1, Kayo Nomura, Shinji Kawahito
1Department of Anesthesiology and Clinical Research, National Hospital Organization Zentsuji Hospital, Zentsuji 765-8507.
Masui. the Japanese Journal of Anesthesiology
|December 15, 2012
Summary
Dextran 40 infusion during general anesthesia caused anaphylactic shock in a patient, leading to severe hypotension and desaturation. Prompt treatment with adrenaline and hydrocortisone resolved the shock, allowing the surgery to proceed safely.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- General anesthesia involves complex physiological management.
- Dextran, a plasma expander, is used for volume replacement and thromboembolism prevention.
Observation:
- A patient undergoing partial hepatic resection developed severe hypotension, tachycardia, and desaturation during anesthesia.
- These symptoms occurred shortly after the intravenous infusion of Saviosol (dextran 40).
Findings:
- The clinical presentation was diagnosed as anaphylactic shock.
- Intravenous administration of adrenaline and hydrocortisone rapidly improved the patient's hemodynamic status and oxygenation.
Implications:
- Low molecular weight dextran can precipitate severe adverse reactions, including anaphylaxis, during general anesthesia.
- Anesthesiologists must be vigilant for dextran-induced anaphylaxis and prepared for prompt management.
- This case highlights the potential risks associated with dextran use in surgical patients.
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