1 case of allergy in defluorane surgery

The patient, male, 73 years old, mainly due to "trauma to the right hip pain with dysfunction more than 1h" hospital, after the injury no coma, vomiting, no chest pain and panic, shortness of breath and so onAdmission: T36.8C, P64/min, R20/min, BP163/84mmHg, back tenderness, pain to the lower back section, lower-spine tenderness, pain, back movement is limitedThe upper part of the right thigh is deformed, swelling tenderness, can be a clear bone rub, movement disorder; The end of the right lower limb feels normal movement, the end circulation can beThe pelvis and the rest of the limbs are not present with significant abnormalitiesAlways in good healthlaboratory examination: coagulation function: D-dipolymer 1.54mg/L; blood routine: white blood cell 13.21 x 109/L, hemoglobin 125g/L, number of neutrophils 10.41 x 109/L; liver and kidney function: glutamine transferase 72.6U/LPreoperative 1d review blood routine: hemoglobin 116g/L; Clotting function: D-dipolymer 4.74mg/L; red blood cell deposition rate of 96mm/himaging examination: right femur near end CT flat sweep and 3D reconstruction: (1) right femur rough fracture, broken end dislocation into a corner, around see a little dot-like free bone shadow; DR: right femur upper section fracture, two foldend situated, bad lineLumbar CT: (1) lumbar 2-3, 3-4, 4-5, 5-1 vertebral disc mild swelling; (2) lumbar degenerative change; (3) lumbar 4 vertebral bone damage see soft tissue density, please combine medical history for further examinationheart color super: enlarged left room, aortic sinus slightly wider, room space slightly thicker, two-tip valve rear valve calcium spot formation, three-tip valve reflux (mild), left chamber contraction function measurement is normal, diastolic function decreasedTheof the limbscolor ultrasound Doppler: the right calf veinthrombosisLumbar flat sweep MRI: (1) lumbar 4 vertebral bone damage, affected with the right vertebral arch, the back vertebral vertebral tube narrowed, pathological fracture may, recommended further examination, chest 9, chest 11, waist 1, waist 5 and waist 4 vertebrae left attachment knotand and flaky abnormality Signals, nature to be determined; (2) lumbar vertebral hyperplifying, lumbar end plate degeneration, lumbar vertebral signal uneven; (3) lumbar disc degeneration partner protruding, adjacent epidural frontal edge pressure; (4) lower lumbar subcutaneous and part of the muscles swelling, lumbar jaundice ligament thickeningdiagnosis : 1 near-end fracture of right femur (wADDELLb type); 2 Lum4 vertebral bone damage, nature to be checked Anaesthetic and Surgical Treatment: Life Signs in The Operating Room: P:92/min, R:14/min, BP: 141/81mmHg; 08:55 Anaesthesia Induced: Propphelia Plasma Target Concentration 3 sg/ml; Shufentani 15 sg, Riffentani plasma target concentration 2 mg/ml; Shunqu aku ammonium 7 mg, 7 mg .0 intubation is smooth, anesthesia maintenance: defluorane vol%5.5; Riffentani plasma target concentration of 3 ?g/ml; input lactic acid Ringer liquid and polygelatin peptides for liquid management ; 09:45 surgery began, surgery began 10min, BP reduced to: 85 to 95/45 to 55mmHg, P to: 60 to 70 times/ min After that, the change of vital signs is shown in Table 1, the end time of the operation is 11:20, the end time of anesthesia is 11:45, and the patient is returned to the ward after surgery the change of the patient's vital signs and treatment discussion defluorane is an inhaled anesthetic, its blood gas distribution coefficient is low, induces and wakes up quickly, wakes up quality is better than other general anaesthetic Defluorane is used in general anesthesia in cardiac surgery, neurosurgery, outpatient surgery, pediatrics and other surgical fields, with higher quality and less limitation than other inhaled anesthetics (fluoran, isfluoroethane, heptafluorane), and its rapid elimination from the body reduces the frequency of complications associated with the upper respiratory tract and hypoxemia, promotes early cessation of artificial ventilation, reduces narcolel, and promotes the recovery of muscle tension after surgery in recent years, domestic and foreign reports of tetrafluorane can cause oxidative damage of the liver, its role can be met with thiamin phosphate, in addition, the study found that allergies and auto
immune mechanism in the liver damage caused by tefluorane play a key role Reported that a routine colon cancer removed elderly patients, using defluorane after general anesthesia after severe acute liver injury In polio, a certain percentage of children with defluorane were active lyson after surgery, while the incidence of postoperative restlessness was higher after the use of heptafluorane polygenog peptides can also cause allergic reactions, the composition of which is a healthy bovine bone or pig bone gumsolution made of sterilized water solution, infusion or after infusion can occur low blood pressure, tachycardia, tachycardia, tachycardia, breathing difficulties and urticaria and other allergic reactions In this case, patients in the use of polygenog peptides and defluorine after the occurrence of pulse oxygen saturation, blood pressure continued to reduce, airway pressure continuous increase and other reactions, after the discontinuation of all narcotic drugs and polygenosis peptides, the use of epinephrine, aerate to rescue, the patient's blood pressure, heart rate, pulse oxygen saturation gradually recovered to normal levels, airway pressure reduced to normal levels After the re-use of polygenosis peptide infusion, its vital signs to maintain stability, however, again on the end of the defluorane for inhalation anesthesia maintenance, the pulse oxygen saturation, blood pressure continued to reduce, airway pressure continuous increase and other reactions, immediately after the defluorane recovery of its vital signs to normal, thus the initial diagnosis the patient in surgery occurred in the allergic reaction of defluorane