Because of rarity of its incidence, a case of anaphy lactic hypotension developed following thiopental :administration is reported with a brief review of the literature.
This 55 year old female, at another hospital, twice cancelled proposed cholecystectomy due to hypotension to thiopental induction with 250 mg and 200 mg respectively.
At the admission time, she had no abnormalities on C.B.C., urinalysis, E.K.G., chest X-ray, Thorn test and urine porphyrin test except increased alkaline phosphotase in liver function test and positive amobarbital test with 200 mg.
This patient was premeditated with atropine 0.3 mg. only without sedatives. Difficult induction with nitrous oxide and halothane in this non-cooperative patient was supplemented by 2.5% thiopental 4 ml. in divided doses. At this point blood pressure dropped from 140/90 mmHg. To 80/60 mmHg. 100% oxygen was, therefore, administered by the mask and 20mg, of ephedrine was given intravenously and intubated following succinylcholine. After intubation blood pressure rose to 140/80 mmHg. Two hours later the patient had apparently fully recovered. Postoperative course was uneventful.
It was confirmed that this rare reaction during anesthesia was due to thiopental by intravenous testing with divided doses of the durg.
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