Anaes Cases · Anaphylaxis under anaesthesia
Flushing in recovery after a resolved hypotensive episode
A short case on the late-presenting cutaneous signs — the flushing/urticaria that appeared after the cardiovascular event resolved, confirming that the hypotension was anaphylaxis. The importance of tryptase and referral.
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Prompt
A patient had an unexplained fall in blood pressure 10 minutes after antibiotic prophylaxis at induction, which resolved with a vasopressor. In recovery, widespread urticaria is noted. Discuss.
Presentation
A 50-year-old man had an unexplained fall in blood pressure (to 70 systolic) about 10 minutes after the administration of cefazolin at induction, which was treated with a bolus of metaraminol and resolved within 5 minutes. The surgery proceeded uneventfully. In the recovery room, the nurse notes widespread flushing and urticaria over his chest and arms.
References2ShowHide
- [4]Littlejohns A, Savic S, Hopkins PM, et al. Diagnostic certainty after investigation of perioperative hypersensitivity. British Journal of Anaesthesia, 2026.PMID 41680037
- [5]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.