PERIOPERATIVE ANAPHYLAXIS – OUR EXPERIENCE OF TWO CASES

Abstract

Anaphylactic reactions during intraoperative period are difficult to diagnose because of the anaesthetized state of the patient. During the perioperative period, any event relating to sudden-onset haemodynamic collapse or increased airway pressures during certain surgical procedures should raise suspicion of anaphylaxis. Though cited as rare in the western world, echinococcus infection is common in India, resulting in an increased ratio of cases, as and when compared to the western world. We report of two cases of perioperative anaphylaxis for hydatid disease surgery during 3 years period. Anaphylaxis is a medical emergency requiring prompt intervention. Although protocols vary in some of the details of management, adrenaline is the mainstay of treatment and early administration saves lives. However, even with prompt appropriate treatment, anaphylaxis can still kill, as our first case reports. From our experience, we suggest use of 100 % oxygen during the intraoperative period and maintaining anaesthesia with intravenous agents so that in case of an untoward catastrophic event, cerebral hypoxia may be delayed  Increased reports of successfully managed cases will help in future references and  in formulating guidelines of management .