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KMID : 1155520190140040412
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Anesthesia and Pain Medicine
2019 Volume.14 No. 4 p.412 ~ p.415
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Anaphylactic reaction with hydroxyethyl starch during anesthesia - A case report -
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Kim Gunn-Hee
Kim Go-Eun
Kwon Mi-Young
Koo Min-Seok
Yun Mi-Jung
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Abstract
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Background: Hydroxyethyl starch (HES), a class of synthetic colloid solutions, has been widely used to treat perioperative hypovolemia. The use of HES, however, is associated with the risk of allergic reactions.
Case: An 83-year-old man was scheduled to undergo an open reduction and internal fixation of a pertrochanteric fracture under spinal anesthesia. He had no history of allergy. Five minutes after HES administration, hypotension, agitation, and skin rash were developed. HES infusion was terminated due to a suspected anaphylactic reaction. The vital signs recovered following administration of phenylephrine, dexamethasone, and hydrocortisone. Serum tryptase and total immunoglobulin E levels were elevated in plasma samples collected following the commencement of the allergic reaction during surgery.
Conclusions: In the present report, the risk of anaphylactic reaction with HES and the laboratory tests needed to support the diagnosis are highlighted.
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KEYWORD
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Anaphylaxis, Anesthesia, Spinal, Starch
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