Intra-Anesthetic Anaphylactic Shock Due to Rocuronium: Diagnosis and Treatment

<p><strong>Introduction</strong>: Intraoperative anaphylactic events are rare, but are important to pay attention to as they are associated with morbidity and mortality rates. Intraoperative anaphylactic events can be caused by anesthetic drugs including muscle paralysis, rocuronium, succinylcholine and attracurium are the most common causes of intraoperative anaphylaxis.</p><p><strong>Case Illustration</strong>: An 11-year-old girl diagnosed with 3rd degree microtia with severe conductive hearing loss in the right ear. It is planned to undergo stage 1 auriculoplasty measures accompanied by rib harvesting. After induction of anesthesia with the administration of rocuronium as a muscle relaxant. Patients are suspected of anaphylaxis due to a decrease in blood pressure, increased pulse and low EtCO2 levels. Anaphylactic management is done quickly so that the patient experiences good resolution.</p><p><strong>Conclusion</strong>: The cause of anaphylaxis during intraoperative occurrence is caused by muscle relaxant, one of which is rocuronium where most likely the cause of anaphylaxis that occurs in patients due to rocuronium administration. In addition to observing the patient's blood pressure and pulse, a decrease in EtCO2 can be a sign of anaphylactic activity. The initial goals of anaphylactic treatment are improving cardiovascular homeostasis, intravenous epinephrine administration and intravascular volume replenishment. Proper recognition and management of intraoperative anaphylactic events will provide a good prognosis.</p>