Propofol induced perioperative anaphylaxis: A case report

Abstract

Background: Although propofol is one of the most commonly used drugs for induction of anaesthesia, it is not devoid of anaphylactic  potential. Early detection of any suspected anaphylactic reaction during anaesthesia, identification of the offending agent, prompt  management and prevention of exposure to the offending agent in the future is the responsibility of the anaesthesiologist. This is a case  report of anaphylaxis to propofol at induction of anaesthesia in a previously nonallergic 9year old boy who had right herniotomy done  and responded to epinephrine injection.

Case Report: A9yr old male child who had right herniotomy on account of right communicating hydrocele. Preoperative history was not  remarkable. Intraoperative period was complicated by an anaphylactic reaction following administration of propofol at induction and was  subsequently managed by securing the airway and adrenaline administration. Postoperatively he had bronchospasm/laryngospasm  which was also managed successfully. He was transferred to PACU and monitored closely for several hours before he was  discharged to the ward.

Conclusion: Early recognition and administration of adequate adrenaline is the mainstay of anaphylaxis management. Anaphylaxis is a  clinical diagnosis, and tests such as total plasma tryptase are only supportive of the diagnosis. The anaesthesiologist plays a key role in  coordinating care for the patient during and after a perioperative anaphylaxis event.