A case report on succinylcholine hypersensitivity presenting as severe bronchospasm
Journal Title: Indian Journal of Pharmacy and Pharmacology - Year 2019, Vol 5, Issue 4
Abstract
Succinylcholine is a depolarizing neuromuscular blocking agent useful as an adjunct to general anaesthesia Hypersensitivity to succinylcholine might lead to flushing skin rash bronchospasm and shock However incidence of bronchospasm is less common in man A 26 years old female patient at our setup while undergoing dilatation and evacuation procedure was administered with Injection Scoline Succinylcholine 50 milligrams intravenous Within a minute patient was gasping and underwent severe bronchospasms Her SpO2 was 94 along with development of crepitation with tachypnoea and spasms 30 respirationsminute She was immediately resuscitated and intubated by the attending anaesthetist treated for bronchospasm as well as shifted on ventilator Within few hours she was taken off the ventilator and extubated She was stable then and discharged after two days Hypersensitivity to NMBAs low incidence of 1 in 6000 20000 NMBAs have a direct effect on mast cells thereby causing hypersensitivity reactions Succinylcholine is considered to have 1 histamine releasing activity of tubocurarine producing serious hypersensitivity reactions This histamine released acts on the effector endreceptors in bronchial wall leading to bronchoconstriction and sometimes a fullblown spasm If timely management failed it can result into an anaesthetic disaster Rechallenge with succinylcholine was avoided due to possibility of fatal consequences According to WHO UMC criteria Naranjo Scale for causality assessment causality was termed as ProbableKeywords Bronchospasm Hypersensitivity Lifethreatening Neuromuscular Blocking Agent NMBA Suspected adverse drug reaction
Authors and Affiliations
Sapna D. Gupta, Haiya J Sheth, Supriya D. Malhotra, Pankaj R. Patel
Keywords
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- EP ID EP478576
- DOI 10.18231/2393-9087.2018.0044
- Views 98
- Downloads 0
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