Case Report

Fentanyl not an Exception to Anaphylaxis


Intraoperative anaphylaxis can lead to significant morbidity and mortality but rarely occurs. Vascular collapse and bronchospasm are the hallmarks of this condition. numerous agents have been identified as triggers of intraoperative anaphylaxis, the most common being neuromuscular blocking drugs and latex. But opioids rarely cause anaphylaxis. We report an unusual case of intraoperative anaphylaxis with pulmonary edema during a routine plastic surgery procedure was due to iv fentanyl.

[1] Mertes PM, Alla F, TRechot P, Auroy Y, Jougla E. Anaphylaxis during anesthesia in France: an 8-year national survey. J Allergy Clin Immunol. 2011; 128(2): 366-73.
[2] Mertes PM, Laxenaire MC, Leinhart A, Aberer W, Ring J, PichlerWj, et al. Reducing the risk of anaphylaxis during anaesthesia: a guideline for clinical practice. J Invest Allegol ClinImmunol. 2005; 15(2):91-101.
[3] Roizen MF, Fleisher LA. Anesthetic implications of con¬current diseases. In: Miller RD (Ed.). Anesthesia, 6th ed. Philadelphia: Elsevier; 2005: 1092–1093.
[4] Dewachter P, Mouton-Faivre C, Emala CW. Anaphylaxis and anesthesia: controversies and new insights, Anesthesiology. 2009; 111:1141-50.
[5] Fukuda T, Dohi S. Anaphylactic reaction to fentanyl or preservative. Can Anaesth Soc J. 1986; 33(6):826-7.
[6] Zuker-Pinchoff B, Ramanathan S. Anaphylactic reaction to epidural fentanyl. Anesthesiology 1989; 71(4):599-601.
[7] Gallerani M, Manzoli N, Fellin R, Simonato M, Orzincolo C. Anaphylactic shock and acute pulmonary edema after a single oral dose of acetazolamide. Am J Emerg Med. 2002; 20(4): 371–372.
[8] Low I, Stables S. Anaphylactic deaths in Auckland, New Zealand: a review of coronial autopsies from 1985 to 2005. Pathology. 2006; 38(4): 328–332
[9] Levy JH. The Allergic Response. In: Barash PG, editor. Clinical Anesthesia. 8th ed. Philadelphia: Wolters Kluwer; 2017. P. 552-90.
IssueVol 7 No 1 (2021): Winter QRcode
SectionCase Report(s)
Fentanyl Anaphylaxis Pulmonary edema

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Thirunavukkarasu M, Vinay V, Eda J, Gupta B. Fentanyl not an Exception to Anaphylaxis. Arch Anesth & Crit Care. 7(1):53-5.