Prophylactic Antibiotic Administration Induced Bronchospasm as Increased Airway Pressure During General Anesthesia

Received 12 August 2009; accepted 28 December 2009.

Background

Anaphylactic reaction induced bronchospasm as wheezing and severe elevation of airway pressure was observed in a succession of patients during general anesthesia at our institute in November 2007. The aim of this survey was to investigate the suspected causes and risk factors of these anaphylactic reactions and the degree of correlation.

Methods

All patients who received general anesthesia between November 1 and November 10, 2007 were enrolled. Underlying diseases, substances including intravenous and inhalational anesthetics, antibiotics, and the degree of increase in airway pressure were recorded. Enrolled patients were divided into a significant-airway-pressure-elevation group (Group P) and a no-airway-pressure-elevation group (Group N).

Results

A new brand of cephalexin (Roles®) used as a prophylactic antibiotic was identified as the most likely causative substance of this succession of suspected anaphylactic reactions (28 in 185 patients, 15.14%), and rapid administration was a contributor to these anaphylactic reactions.

Conclusion

In this study, we found that rapid administration of Roles® was the main cause of suspected anaphylactic reaction presenting as bronchospasm with severe elevated airway pressure. Using Roles® as the prophylactic antibiotic is not recommended in patients receiving general anesthesia.

Key Words: airway pressure , anaphylactic reaction , antibiotic , bronchospasm , cephalosporin , patient safety

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Article Outline

• Abstract

• References

• Copyright

References

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Department of Anesthesiology, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.

Correspondence to: Dr Pin-Tarng Chen, Department of Anesthesiology, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, R.O.C.

PII: S1726-4901(10)70005-8

doi:10.1016/S1726-4901(10)70005-8

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