A case of propofol-induced oropharyngeal angioedema and bronchospasm
- PMID: 22211170
- PMCID: PMC3242060
- DOI: 10.4168/aair.2012.4.1.46
A case of propofol-induced oropharyngeal angioedema and bronchospasm
Abstract
Propofol (2,6-diisopropylphenol) is an ultrashort-acting sedative agent with sedative and amnestic effects that is used not only for anesthesia but also for sedation during minor outpatient procedures and endoscopic examinations. Rare cases of anaphylaxis following propofol administration have been reported in the medical literature. Documentation of anaphylaxis is often lacking because the cause and effect relationship is often hard to prove. Only a minority of patients get referred for allergy testing to confirm the offending drug. Here we report a 74-year-old woman who had an anaphylactic reaction with severe oropharyngeal edema and bronchospasm for a few minutes after receiving propofol during endoscopic examination. An allergy skin test was positive for both propofol and soybean. Soybean in the intralipid is one component of propofol, and we concluded that this anaphylaxis was caused by soybean.
Keywords: Bronchial spasm; anaphylaxis; angioedema; propofol.
Conflict of interest statement
There are no financial or other issues that might lead to conflict of interest.
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References
-
- Shafer A, Doze VA, Shafer SL, White PF. Pharmacokinetics and pharmacodynamics of propofol infusions during general anesthesia. Anesthesiology. 1988;69:348–356. - PubMed
-
- Dewachter P, Mouton-Faivre C, Castells MC, Hepner DL. Anesthesia in the patient with multiple drug allergies: are all allergies the same? Curr Opin Anaesthesiol. 2011;24:320–325. - PubMed
-
- Kroigaard M, Garvey LH, Gillberg L, Johansson SG, Mosbech H, Florvaag E, Harboe T, Eriksson LI, Dahlgren G, Seeman-Lodding H, Takala R, Wattwil M, Hirlekar G, Dahlén B, Guttormsen AB. Scandinavian Clinical Practice Guidelines on the diagnosis, management and follow-up of anaphylaxis during anaesthesia. Acta Anaesthesiol Scand. 2007;51:655–670. - PubMed
-
- Harper NJ, Dixon T, Dugué P, Edgar DM, Fay A, Gooi HC, Herriot R, Hopkins P, Hunter JM, Mirakian R, Pumphrey RS, Seneviratne SL, Walls AF, Williams P, Wildsmith JA, Wood P, Nasser AS, Powell RK, Mirakhur R, Soar J Working Party of the Association of Anaesthetists of Great Britain and Ireland. Suspected anaphylactic reactions associated with anaesthesia. Anaesthesia. 2009;64:199–211. - PMC - PubMed
-
- Ebo DG, Fisher MM, Hagendorens MM, Bridts CH, Stevens WJ. Anaphylaxis during anaesthesia: diagnostic approach. Allergy. 2007;62:471–487. - PubMed