A case of anaphylactic shock leading to cardiopulmonary arrest during transurethral lithotripsy under spinal anesthesia

Abstract

A 76-year-old man with a permanent pacemaker was scheduled for transurethral lithotripsy. He had a past history of drug allergy, which we were not informed preoperatively. About 40min after spinal anesthesia, he suddenly developed hypotension which did not respond to intravenous fluids and ephedrine. Subsequently, he became cardiopulmonary arrest and ventricular fibrillation. He was successfully resuscitated without any neurological sequelae. Erythema appeared on the lower abdomen, suggesting the occurrence of anaphylactic shock. The cause of anaphylactic shock was considered to be a disinfectant, chlorhexidine gluconate, or an additive agent, methylparaben.