Fixed drug eruption associated with anaesthesia

We report the case of a 65-yr-old woman undergoing bronchoscopy for a lobular lesion who received thiopentone to induce anaesthesia that was maintained with sufentanil, vecuronium and isoflurane. She tolerated the procedure well initially, but developed eruptions about her face and fingers within 24 hr of anaesthesia. Treatment with flucinonide cream (0.05%) resolved the eruptions with no lasting sequelae. Literature review supported the suspicion that the offending agent may have been thiopentone, so when a lobectomy was subsequently required and the patient refused investigation to identify the causative agent, propofol was employed as an alternative to induce anaesthesia. The surgery was well tolerated and the patient was discharged after an uneventful postoperative course. This case is reported to heighten awareness of the delayed onset of adverse effects which may be associated with the use of thiopentone.