SPİNAL ANESTEZİ SIRASINDA PANTOPRAZOLE BAĞLI ANAFİLAKSİ: OLGU SUNUMU

Öz

Anafilaksi, anestezi sırasında gelişebilen nadir ancak potansiyel olarak yaşamı tehdit eden sistemik bir aşırı duyarlılık reaksiyonudur (1). Anestezi altında ortaya çıktığında tanı ve tedavi gecikebilir. En yaygın nedenler arasında nöromüsküler bloke edici ajanlar, antibiyotikler, lateks ve nadiren proton pompa inhibitörleri yer alır (2). Bu olguda, spinal anestezi altında intravenöz pantoprazol uygulanmasını takiben gelişen bir anafilaktik reaksiyon sunulmuştur.

Anahtar Kelimeler

• Anafilaksi
• Pantoprazol
• Proton pompa inhibitörü
• Spinal anestezi
• Triptaz

PANTOPRAZOLE-INDUCED ANAPHYLAXIS DURING SPINAL ANESTHESIA: A CASE REPORT

Öz

Anaphylaxis is a rare but potentially life-threatening systemic hypersensitivity reaction that may occur during anesthesia (1). When it occurs under anesthesia, diagnosis and treatment can be delayed. The most common causes include neuromuscular blocking agents, antibiotics, latex, and, rarely, proton pump inhibitors (2). We report an anaphylactic reaction that developed after intravenous pantoprazole administration under spinal anesthesia.

Anahtar Kelimeler

• Anaphylaxis
• Pantoprazole
• Proton pump inhibitor
• Spinal anesthesia
• Tryptase

Kaynakça

1. Harper NJN, Cook TM, Garcez T, Farmer L, Floss K, Marinho S, Torevell H, Warner A, Ferguson K, Hitchman J, Egner W, Kemp H, Thomas M, Lucas DN, Nasser S, Karanam S, Kong KL, Farooque S, Bellamy M, McGuire N. Anaesthesia, surgery, and life-threatening allergic reactions: Epidemiology and clinical features of perioperative anaphylaxis in the 6th National Audit Project (NAP6). Br J Anaesth. 2018;121(1):159-171. doi:10.1016/j.bja.2018.04.014
2. Low AE, McEwan JC, Karanam S, North J, Kong KL. Anaesthesia-associated hypersensitivity reactions: Seven years’ data from a British bi-specialty clinic. Anaesthesia. 2016;71(1):76-84. doi:10.1111/anae.13273
3. Dewachter P, Savic L. Perioperative anaphylaxis: pathophysiology, clinical presentation and management. BJA Educ. 2019;19(10):313-320. doi:10.1016/j.bjae.2019.06.00
4. Telaku S, Veliu A, Zenelaj Q, Telaku M, Fejza H, Alidema F. Anaphylaxis caused by taking pantoprazole: Case series. Eur J Case Rep Intern Med. 2023;10(9):004017. doi:10.12890/2023_004017. PMID: 37680781; PMCID: PMC10482135.
5. Osman BM, Maga JM, Baquero SM. Case report: Management of differential diagnosis and treatment of severe anaphylaxis in the setting of spinal anesthesia. J Clin Anesth. 2016;35:145-149. doi:10.1016/j.jclinane. 2016.07.009