PMID: 8594963Dec 1, 1995Paper

Life-threatening postoperative angioedema following treatment with an angiotensin converting enzyme inhibitor

Der Anaesthesist
C Maier

Abstract

Angio-oedema is a recognised complication of angiotensin converting enzyme (ACE) inhibitor therapy, occurring in 0.1% to 0.5% of patients taking captopril, enalapril, or lisinopril. This is the first report of severe angio-oedema complicating therapy with quinapril, a new, long-acting drug. CASE REPORT. A 74-year-old female had been taking quinapril (10 mg/day) and diuretics (fixed combination of triamterene and hydrochlorothiazide) for arterial hypertension for 18 months without any complication. After a fracture of the ankle, the patient received spinal anaesthesia uneventfully for an osteosynthesis. Ten days postoperatively, she noted swelling of the lips and the left half of the tongue. Following intravenous injection of antihistamines and prednisolone, these symptoms regressed. However, a relapse occurred on the 16th postoperative day with rapidly increasing oedema of the lips, face, ventral collar area, and entire tongue. Despite high-dose steroids, dyspnoea developed within 2 h. Direct laryngoscopy was impossible, and a flexible bronchoscope was used for nasotracheal intubation. At this point, the diagnosis of ACE inhibitor-induced angio-oedema was made and quinapril was withdrawn. The patient recovered, tracheal extubat...Continue Reading

Citations

Sep 22, 2006·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Putul SarkarGeorge Hall
Feb 6, 2004·Critical Reviews in Oral Biology and Medicine : an Official Publication of the American Association of Oral Biologists·Lis Andersen TorpetBirgitte Nauntofte

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