How do you recognize and treat perioperative anaphylaxis?

Abstract

A 60-year-old female is scheduled to have an elective umbilical hernia repair. Preoperative evaluation revealed a past medical history of hypertension, obesity, and well-controlled type II diabetes mellitus. Her home medications include lisinopril, 10 mg, once a day, and metformin, 1000 mg, twice a day. The surgical history includes 2 previous cesarean sections and an elective abdominoplasty done at an outside facility. The patient reported no history of complications associated with her prior anesthetic exposure and no history of allergies. Physical examination was relevant for a moderately obese female with good dentition and a Mallampati 2 airway. The patient was given an ASA classification of 2.