Catecholamine-resistant cardiovascular collapse after propofol, atracurium and gentamicin

Area of Science:

• Anesthesiology
• Pharmacology
• Critical Care Medicine

Background:

• Intravenous drug administration for surgical procedures carries inherent risks.
• Propofol, atracurium, and gentamicin are commonly used agents in anesthesia and perioperative care.

Observation:

• A 43-year-old male developed sudden cardiovascular collapse immediately following intravenous administration of propofol, atracurium, and gentamicin.
• The patient presented with signs suggestive of an acute drug reaction.

Findings:

• Cardiopulmonary resuscitation, including fluid resuscitation and vasopressors (adrenaline and noradrenaline), was initiated promptly.
• The patient achieved full recovery without any neurological deficits.
• No significant biochemical abnormalities were identified during the event or recovery.

Implications:

• This case underscores the importance of recognizing and managing rare but severe adverse drug reactions during anesthesia.
• Vigilant monitoring and rapid intervention are crucial for improving outcomes in patients experiencing cardiovascular collapse.
• Further investigation into the specific mechanisms of this acute drug reaction may inform future clinical practice and patient safety protocols.