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Anaphylaxis to propofol during cerebral aneurysm clipping
E J Phillips1, R Tran1, A Brahmbhatt1,2
1Department of Anaesthesia and Acute Pain Medicine St. Vincent's Hospital Melbourne Australia.
Anaesthesia Reports
|July 26, 2026
Summary
Anaphylaxis during anesthesia is rare but serious. This case report highlights a suspected propofol anaphylaxis, emphasizing early recognition and allergy testing for diagnosis.
Area of Science:
- Anesthesiology
- Immunology
- Allergy
Background:
- Anaphylaxis is a severe hypersensitivity reaction, often linked to peri-operative medications like neuromuscular blocking agents and antibiotics.
- Propofol, a common anesthetic induction agent, rarely causes anaphylaxis.
- Previous exposure to propofol may increase the risk of subsequent anaphylactic reactions.
Purpose of the Study:
- To report a case of suspected propofol anaphylaxis in a patient undergoing cerebral aneurysm clipping surgery.
- To emphasize the importance of recognizing early signs of anaphylaxis in the peri-operative setting.
- To highlight the role of prompt management and allergy skin testing in diagnosing propofol-induced anaphylaxis.
Main Methods:
- Case report detailing a 51-year-old male patient with suspected propofol anaphylaxis.
- Review of the patient's medical history, including prior propofol exposure.
- Description of the peri-operative management and diagnostic workup, including allergy skin testing.
Main Results:
- The patient experienced a suspected anaphylactic reaction post-induction with propofol.
- Prompt recognition and management of the anaphylaxis were initiated.
- Follow-up allergy skin testing was performed to investigate the suspected propofol allergy.
Conclusions:
- Propofol anaphylaxis, though rare, can occur even after previous uneventful exposures.
- Early identification of anaphylaxis signs and immediate intervention are critical for patient outcomes.
- Allergy skin testing is essential for confirming propofol hypersensitivity and guiding future anesthetic choices.
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