The management of general anesthesia in a case with polyethylene glycol and polysorbate allergy: a case report

Polyethylene glycol (PEG) and polysorbate 80 are ingredient in various medical products including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine. However, little is known about the relationship between these allergy and general anesthesia. We present a case of a 41-year-old woman was scheduled to undergo left partial mastectomy. She had a history of PEG and polysorbate 80 allergy. We administered antihistamine and corticosteroid before surgery as pre-treatment considering the possibility of pseudoallergy in addition to avoiding exposure to PEG/polysorbate. Despite the pre-treatment, redness was noted around the patient’s face and neck upon injection of Propofol 100 mg. However, after administration of additive antihistamine, the lesion disappeared without any allergic symptoms. Propofol, remifentanil and rocuronium with sevoflurane were used for induction and maintenance of the general anesthesia. Following the completion of surgery, the muscle relaxant was reversed by sugammadex. The patient was discharged without any complications. This case report aims to review the relevant patient population and provide guidance for safe surgical management.

Allergy; Anesthesia; COVID-19; Polyethlene glycol; Polysorbate 80

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