Abstract
BackgroundThe efficacy of glucagon for adrenaline-resistant anaphylactic shock in patients taking β-blockers is controversial. However, understanding the efficacy of glucagon is important because adrenaline-resistant anaphylactic shock is fatal. We present a case of severe adrenaline-resistant anaphylactic shock in a patient taking a β-blocker, and glucagon was effective in improving hemodynamics.Case presentationAn 88-year-old woman with severe aortic stenosis and taking a selective β-1 blocker underwent transcatheter aortic valve implantation under general anesthesia. Postoperatively, she received 100 mg sugammadex, but 2 min later developed severe hypotension and bronchospasm. Suspecting anaphylactic shock, we intervened by administering adrenaline, fluid loading, and an increased noradrenaline dose. Consequently, the bronchospasm improved, but her blood pressure only increased minimally. Therefore, we administered 1 mg glucagon intravenously, and the hypotension resolved immediately.ConclusionsGlucagon may improve hemodynamics in adrenaline-resistant anaphylactic shock patients taking β-blockers; however, its efficacy must be further evaluated in more cases.
Highlights
The efficacy of glucagon for adrenaline-resistant anaphylactic shock in patients taking β-blockers is controversial
Glucagon may improve hemodynamics in adrenaline-resistant anaphylactic shock patients taking β-blockers; its efficacy must be further evaluated in more cases
Glucagon may be effective in improving hemodynamics in patients taking β-blockers regularly [3, 4]
Summary
The efficacy of glucagon for adrenaline-resistant anaphylactic shock in patients taking β-blockers is controversial. Conclusions: Glucagon may improve hemodynamics in adrenaline-resistant anaphylactic shock patients taking β-blockers; its efficacy must be further evaluated in more cases. Background adrenaline is the first-line treatment for anaphylactic shock, its efficacy may be limited in patients taking β-blockers regularly [1].
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