Anaphylactic Bronchospasm during Induction of General Anaesthesia: A Case Report

Binod Gautam,Rashna Shakya

doi:10.31729/jnma.4304

Abstract

Bronchospasm represents the clinical manifestation of bronchial muscles contraction resulting in reduced alveolar air flow. Non-allergic mechanisms or anaphylaxis underlie the genesis of perioperative bronchospasm, a potential anaesthetic disaster. Early recognition and treatment are crucial. We report a rare incident of anaphylactic bronchospasm without hypotension during general anaesthesia. Urticaria appeared in chest and abdomen suggesting anaphylaxis. After the event resolved with bronchodilators, surgery continued uneventfully. Vecuronium was the most probable culprit but confirmation was not possible as the patient was lost to follow up. Rarely, perioperative anaphylaxis presents only with bronchospasm that requires prompt attention to avoid adverse outcome. Keywords: allergy; anaphylaxis; bronchial spasm; general anesthesia.

Highlights

Bronchospasm occurring during anaesthesia is not unusual
Bronchospasm is attributed to anaphylaxis in 14% of cases.[1]
Being rare but potentially grievous, we report an incident of anaphylactic bronchospasm with urticaria and without hypotension that occurred during induction of general anaesthesia in a young male undergoing laparoscopic cholecystectomy

Summary

Introduction

Bronchospasm occurring during anaesthesia is not unusual. It accounts for 3% of all intraoperative critical incidents.[1]. Bronchospasm is attributed to anaphylaxis in 14% of cases.[1] Rarely, bronchospasm may be the sole presenting feature of anaphylaxis.[2] Regardless of genesis, it can cause hypoxia, hypotension and may prove fatal even when appropriately treated.[2] Being rare but potentially grievous, we report an incident of anaphylactic bronchospasm with urticaria and without hypotension that occurred during induction of general anaesthesia in a young male undergoing laparoscopic cholecystectomy.

Results

Conclusion