2016 Volume 10 Issue 3 Pages 219-224
Studies conducted outside of Japan have described methods for diagnosing anaphylaxis triggered by general anesthetics and have reported various epidemiological findings. In this study, we used these diagnostic methods and tested two patients who suffered general anesthetic-induced anaphylaxis in order to determine the causative agents and identify alternative anesthetic agents that could be used in such patients. Case 1 : A 31-year-old female presented with hypertension and asthma immediately after the administration of remifentanil hydrochloride, rocuronium bromide, and propofol for uterine myomectomy. Propofol was determined to be the causative agent based on intradermal tests conducted using a 1 : 1000 dilution of propofol. We concluded that ketamine hydrochloride and fentanyl citrate could be used as alternative agents in this patient based on intradermal tests using a 1 : 1 dilution of each agent.
Case 2 : A 53-year-old female presented with upper body flushing and hypertension immediately after the administration of propofol, fentanyl citrate, and rocuronium bromide for laparoscopic cholecystectomy. Rocuronium bromide was determined to be the causative agent based on skin prick tests using a 1 : 1 dilution and an intradermal test involving a 1 : 100 dilution. We concluded that remifentanil hydrochloride and suxamethonium chloride could be used as alternative agents in this patient based on skin prick and intradermal tests.
