Anaphylaxis in the operating room treated with an anaphylaxis response kit: A case report.

Anaphylaxis is a rapidly fatal complication of anesthesia, and it needs to be appropriately diagnosed and treated by anesthesiologists. A 37-year-old man underwent surgery for pneumothorax under general anesthesia. Postoperatively, the train-of four count was four, and sugammadex was administered. Soon after, the patient's oxygen saturation and blood pressure decreased, and skin flushing was noted. We suspected anaphylaxis and administered adrenaline. Once the blood pressure normalized, we administered hydrocortisone, famotidine, and d-chlorpheniramine maleate. Thereafter, his condition stabilized, he recovered well, and he was discharged. Blood samples obtained after the onset of the episode indicated anaphylaxis, and a prick test performed 10 weeks postoperatively confirmed sugammadex as the causative agent. We report a case of sugammadex-induced anaphylaxis, which we could properly diagnose and treat because an anaphylaxis kit was available in our department.

Dyspnea after discharge from hospital due to pulmonary vein thrombosis after video-assisted left upper lobectomy: a case report.

BACKGROUND: Thrombus formation at the pulmonary vein transection site is more common in left upper lobectomy than other lobectomies. We report a case of dyspnea and contrast-enhanced computed tomography (CT) findings of pulmonary vein thrombosis after left upper lobectomy. CASE PRESENTATION: A 68-year-old man with left lung cancer underwent video-assisted thoracoscopic left upper lobectomy under general anesthesia with thoracic epidural analgesia. He had no postoperative complications and was discharged home on the 5th day postoperatively. He visited the outpatient clinic at 8 days after surgery because of dyspnea and underwent contrast-enhanced CT, which revealed a thrombus at the resected edge of the left upper pulmonary vein. Anticoagulation therapy was started. Thereafter, the thrombus shrank, and the patient's dyspnea improved. CONCLUSIONS: Left upper lobe resection is particularly associated with pulmonary venous thrombosis, and dyspnea due to pulmonary venous thrombus may develop late after surgery. Postoperative management methods such as anticoagulation and postoperative pain management should be reexamined.