[A case of life-threatening anaphylactoid reaction caused by povidone-iodine]

A 64 year-old man developed life-threatening anaphylactoid reaction caused by povidone-iodine during induction of anesthesia for elective coronary artery bypass graft surgery. While he had a history of cardiac arrest caused by iodine, he could tolerate contrast material and povidone-iodine for pre-operative coronary angiography with pretreatment of H1 and H2 receptor blockades and methylprednisolone. During the operation and postoperative care we could manage cardiac failure by continuous monitoring of cardiac output (CCO) using pulsed-thermodilution method. We recommend prophylactic use of H1 and H2 receptor blockades for surgical patients who may be at risk for anaphylaxis or anaphylactoid reaction.