Propofol
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Fever and hyperamylasaemia: case report A woman [age at reaction onset not clearly stated] developed a transient high fever and hyperamylasaemia during treatment with propofol for general anaesthesia. The woman, who had cerebral palsy and epilepsy, started to receive dental treatment under general anaesthesia at the age of 14 years. She visited a dental clinic for a regular check-up at age 34 years. Five of her teeth had fourth degree decay and two teeth had restoration detaching. She underwent five dental treatments with restraints and one with anaesthesia induced by midazolam. For her seventh dental treatment, she underwent anaesthesia with IV propofol. Propofol 35mg was continuously administered via bolus at 5–7 mg/kg/h. No problems were noted. For her eighth dental treatment, she received IV propofol 40mg via bolus at 5–7 mg/kg/h. The treatment lasted 60 minutes and she opened her eyes 10 minutes after propofol was stopped. She was monitored for 30 minutes and then went home. Three hours later, her caregiver reported that she was sleepy and her body temperature was 38.2°C. Her body temperature increased to 39.2°C and blood tests revealed an amylase level of 1487 IU/L. The woman was sent urgently to hospital to receive a transfusion and IV antibacterial drugs. She was sent home and her body temperature normalised. She underwent a ninth dental treatment with propofol 40mg via bolus at 5 mg/kg/h. The dental procedure lasted 50 minutes and propofol was stopped. Immediately after the procedure, she developed a fever and her amylase level was again elevated. A palpation test confirmed parotid gland swelling. She went home and her body temperature stabilised at 36.7°C. Subsequent dental treatment was performed without propofol and she did not develop fever, hyperamylasaemia, or parotid gland swelling. Author comment: The hyperamylasemia and elevated body temperature after propofol administration is suspected to be a reaction caused by propofol. Ogasawara T, et al. A case report of hyperamylasemia due to sedation with propofol for dental treatment. Journal of Japanese Dental Society of Anesthesiology 40: 602-603, No. 5, Oct 2012 [Japanese; summarised from a 803082477 translation] - Japan
0114-9954/10/1436-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 26 Jan 2013 No. 1436
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