A case report of anaphylactic shock in a patient undergoing perioperative surgery due to cisatracurium besylate

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Author: XIE Jiqing ¹ KONG Yanru ¹ MA Xiaowen ¹  WANG Huixia ² DONG Yubo ¹ LIU Dehui ³

Affiliation: 1. Department of Pharmacy, The 960th Hospital of Joint Service Support Force of the Chinese PLA, Jinan 250031, China 2. Department of Anesthesiology, The 960th Hospital of Joint Service Support Force of the Chinese PLA, Jinan 250031, China 3. Bio-Research Facility of Jilin Institute of Biology, Changchun 130012, China

Keywords: Cisatracurium besylate Anaphylactic shock Adverse drug reactions

DOI: 10.12173/j.issn.1005-0698.202504116

Reference: XIE Jiqing, KONG Yanru, MA Xiaowen, WANG Huixia, DONG Yubo, LIU Dehui. A case report of anaphylactic shock in a patient undergoing perioperative surgery due to cisatracurium besylate[J]. Yaowu Liuxingbingxue Zazhi, 2025, 34(10): 1224-1227. DOI: 10.12173/j.issn.1005-0698.202504116.[Article in Chinese]  Copied

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Abstract

A 42-year-old male patient developed mild allergic symptoms after the use of cisatracurium besylate in laparoscopic left renal tumor resection, which was relieved by symptomatic treatment. When the drug was added again intraoperatively, the patient's blood pressure decreased sharply from 120/71 mmHg to 50/30 mmHg, and the airway resistance increased from 16 cmH₂O to 38 cmH₂O, and the patient developed typical signs of anaphylactic shock. After immediate intravenous injection of epinephrine, calcium chloride and other drugs, the patient's blood pressure rose to 95/57 mmHg, airway resistance decreased to 20 cmH₂O, and vital signs tended to be stable. The Naranjo's Assessment Scale was used to evaluate and analyze the correlation of suspected drugs. The score was 9 points, indicating that the association between anaphylactic shock and cisatracurium besylate in this patient was judged to be "definitely related". This article suggests that cisatracurium besylate carries an allergic risk and should be used with caution, and the monitoring of vital signs and allergic reactions should be strengthened for early identification and timely treatment to ensure the safety of patients during the perioperative period.

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