Successful management of anaphylactic shock prior to elective cesarean delivery: a case report.

IF 0.8 Q3 ANESTHESIOLOGY

JA Clinical Reports Pub Date : 2024-10-26 DOI:10.1186/s40981-024-00750-z

Kaede Watanabe, Nazuha Mohd Najid, Yusuke Mazda

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引用次数: 0

Abstract

Background: Anaphylactic cardiovascular collapse is complicated by aortocaval compression during pregnancy, exacerbated by neuraxial anesthesia. Despite recommendations to administer perioperative antibiotics before anesthesia, common practice in Japan involves administering them after anesthesia induction. We report a case of possible antibiotics-induced anaphylaxis just before anesthesia for cesarean delivery.

Case presentation: A 24-year-old woman at 37 weeks of gestation presented for a scheduled repeat cesarean under spinal anesthesia. After starting administration of cefazolin prior to anesthesia, she developed anaphylactic symptoms. Hypotension refractory to adrenaline necessitated conversion to an emergency cesarean section under general anesthesia. A neonate was delivered with favorable Apgar scores. Post-delivery, the mother's hemodynamics stabilized significantly. Elevated plasma tryptase confirmed anaphylaxis. Both mother and infant were discharged without further complications.

Conclusions: This case emphasizes the importance of administering prophylactic antibiotic before anesthesia in mitigating severity of shock induced by anaphylaxis and the crucial role of prompt emergency cesarean in achieving successful outcomes.

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选择性剖宫产前过敏性休克的成功处理：病例报告。

背景：过敏性心血管衰竭是妊娠期主动脉瓣受压的并发症，神经麻醉会加重病情。尽管建议在麻醉前使用围手术期抗生素，但日本的普遍做法是在麻醉诱导后使用抗生素。我们报告了一例可能在剖宫产麻醉前使用抗生素引发过敏性休克的病例：一名妊娠 37 周的 24 岁产妇在脊髓麻醉下再次接受剖宫产手术。在麻醉前开始服用头孢唑啉后，她出现了过敏性症状。肾上腺素难治性低血压使她不得不在全身麻醉下进行紧急剖腹产。新生儿顺利娩出，Apgar 评分良好。分娩后，母亲的血液动力学明显稳定。血浆色氨酸酶升高证实为过敏性休克。母亲和婴儿均已出院，未出现其他并发症：本病例强调了麻醉前使用预防性抗生素对减轻过敏性休克引起的休克严重程度的重要性，以及及时进行紧急剖宫产对取得成功结果的关键作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JA Clinical Reports ANESTHESIOLOGY-

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

9 weeks

期刊介绍： JA Clinical Reports is a companion journal to the Journal of Anesthesia (JA), the official journal of the Japanese Society of Anesthesiologists (JSA). This journal is an open access, peer-reviewed, online journal related to clinical anesthesia practices such as anesthesia management, pain management and intensive care. Case reports are very important articles from the viewpoint of education and the cultivation of scientific thinking in the field of anesthesia. However, submissions of anesthesia research and clinical reports from Japan are notably decreasing in major anesthesia journals. Therefore, the JSA has decided to launch a new journal, JA Clinical Reports, to encourage JSA members, particularly junior Japanese anesthesiologists, to publish papers in English language.