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PATIENT SAFETY

Refractory Anaphylactic Cardiac Arrest After Succinylcholine Administration

Antoine Baumann^*, Daniela Studnicska, MD^*, Gérard Audibert, MD, PhD^*, Attila Bondar, MD, FCARCSI^*, Yannick Fuhrer, MD^*, Jean-Pierre Carteaux, MD, PhD, and Paul M. Mertes, MD, PhD^*

From the *Département d’Anesthésie-Réanimation, Hôpital Central, Centre Hospitalier Universitaire, 29, avenue du Maréchal de Lattre de Tassigny, Nancy; and Service de Chirurgie Cardiovasculaire et Transplantation, Hôpitaux de Brabois, Centre Hospitalier Universitaire de Nancy, 54500 Vandoeuvre-les-Nancy, France.

Address correspondence and reprint requests to Antoine Baumann, MD, DESA, Département d’Anesthésie-Réanimation, Hôpital Central, Centre Hospitalier Universitaire, 29, avenue du Maréchal de Lattre de Tassigny, 54000 Nancy, France. Address e-mail to a.baumann{at}chu-nancy.fr.

Abstract

Refractory shock from anaphylaxis can occur after induction of general anesthesia. We report two cases of fatal cardiac arrest with increased blood tryptase and immunoglobulin E values after succinylcholine administration. Tryptase and immunoglobulin E assays may help to identify anaphylactic reactions when cardiac arrest occurs at induction of anesthesia.