[A case of severe bronchospasm and laryngospasm after atracurium administration]

We present a case of severe intraoperative bronchospasm and laryngospasm, that happened after the administration of atracurium 0.5 mg/kg-1; this episode was very difficult to manage, in spite of a prompt bronchodilative treatment. This episode of bronchospasm happened again after extubation and it was so severe that it was necessary to intubate the patient quickly again. We administered bronchodilatative drugs again, and after half an hour it was possible to extubate the patient and to send him to the ward. He had no problems in the postoperative period. We carried on some investigations to evaluate the nature of this reaction: we measured the level of IgE, C3 and C4 complement factor during operation (one sample), in the first and second postoperative days. Moreover we did an intradermal test for all the drugs used during the operation. We concluded that it was an anaphylactoid reaction, sustained by atracurium.