The document describes a case of anaphylactic shock that occurred during general anesthesia in an 80-year-old female patient undergoing surgery for a wrist fracture. Approximately 15 minutes after induction, the patient experienced tachycardia, low end-tidal carbon dioxide, high airway pressure, weak pulse, decreased breathing sounds, and ST depression on EKG. Cardiopulmonary resuscitation was performed and epinephrine was administered. The patient later displayed erythematous changes and was transferred to the ICU. Laboratory tests showed elevated cardiac enzymes indicating a possible cardiac event during the anaphylactic reaction.

1. Anaphylactic Shock in General Anesthesia Presented by R1 顏郁軒 2003/3/18

14. CAUSES OF ANAPHYLAXIS AND ANAPHYLACTOID REACTIONS DURING ANESTHESIA Causes Rate of Reaction (%) Muscle relaxants 61.6 Latex 16.6 Antibiotics 8.3 Hypnotics 5.1 Colloids 3.1 Opioids 2.7 Other (aprotinin, ethylene oxide, local anesthetics) 2.6 Data from French survey by Perioperative Anaphylactoid Reactions Study Group; 1648 patients, July 1994 to December 1996.

15. RECOGNITION OF ANAPHYLAXIS DURING ANESTHESIA System Vital Sign Changes Other Signs Symptoms Pulmonary Increased respiratory rate Stridor (laryngeal edema), wheezing (bronchospasm), coughing, sneezing, decreased pulmonary compliance, pulmonary edema, respiratory failure Dyspnea, chest discomfort Cardiovascular Increased blood pressure Decreased systemic vascular resistance, dysrhythmias, pulmonary hypertension, cardiac arrest Retrosternal pain Increased heart rate Cutaneous Increased skin temperature (redistribution of blood) Urticaria (hives), flushing, periorbital edema, perioral edema diaphoresis Itching, burning Neurologic Nonspecific Disorientation, loss of consciousness Dizziness, light-headedness, malaise Gastrointestinal Nonspecific Vomiting, diarrhea Nausea, abdominal pain

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