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A case of propofol-induced oropharyngeal angioedema and bronchospasm
( Hong Woo Cheon ) , ( Ji Su Han ) , ( Byung Chul You ) , ( An Soo Jang ) , ( Jong Suk Park ) , ( June Hyuk Lee ) , ( Sung Woo Park ) , ( Do Jin Kim ) , ( Choon Sik Park )
UCI I410-ECN-0102-2013-510-002456744
이 자료는 4페이지 이하의 자료입니다.

Introduction: Propofol is a substituted isopropylphenol compound that causes a depression in consciousness. Propofol is thought to be a relatively safe intravenous anesthetic and rare cases of anaphylaxis following propofol administration have been reported. Here we report a patient who experienced an anaphylactic reaction with severe oropharyngeal edema and bronchospasm during few minutes after receiving propofol during endoscopic examination. Case report: A 74-year-old woman visited our hospital to undergo esophagogastroduodenoscopy (EGD) for a check-up. She had an allergy to soybean, but she had no other remarkable medical history. Sedation was induced with 15 mg intravenous propofol. 1 min following administration of propofol, stridor was heard and oxygen saturation fell to 56% on pulse oximetry. We tried to remove the endoscope. But, the endoscope has stuck in her throat and it was not pulled out. We removed the endoscope by compulsion. After 10 seconds endoscope removal, severe wheezing was heard and her oxygen saturation fell to 56%. Marked swelling of the epiglottis was detected. Immediately 1 mg epinephrine was administered subcutaneously, together with 125 mg methylprednisolone was infused intravenously. Because the patient was not improved in symptom after 1 minute, 1 mg epinephrine was administered intravenously. After 1minute, her oxygen saturation recovered to 98%and the wheezing was subsided. Skin-prick tests showed immediate reaction for propofol and 20% Intralipid. So we suspected soybean in intralipid, a component of propofol as the cause of this anaphylaxis. She was informed of the results and of the risk for anaphylaxis if re-exposed to propofol or nutritional supplements containing soybean.

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