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Table 1 Chronological presentation of the events that occurred during endoscopic examination

From: Anaphylaxis caused by butylscopolamine bromide: a case report

Elapsed time (min)EventsVital signs and laboratory data
− 8Pronase® (protease from Streptomyces griseus) and Gascon® (dimethicone) syrup were given orally as pre-medication. 
− 1The patient’s throat was sprayed with 8% lidocaine.HR 69 bpm, BP 96/51 mmHg, SpO2 97%
0Butylscopolamine bromide 10 mg was administered intravenously to minimize gastrointestinal movement. Flunitrazepam 0.2 mg and pethidine hydrochloride 17.5 mg were given intravenously for mild sedation. 
1Endoscopic examination commenced. 
6Since facial cyanosis was observed, 4 L/min oxygen administration was started.HR 144 bpm, BP 70/42 mmHg, SpO2 82%
8Endoscopic examination was stopped.HR 140 bpm, BP unmeasurable, SpO2 72%
10Flumazenil 0.2 mg was administered and a code blue was called.HR, SpO2, and BP undetectable
12The anesthesiologist arrived at the endoscopy center. 
13Endotracheal intubation was performed. Adrenaline 0.3 mg was administered intravenously. 
19BP partially recovered and SpO2 transiently improved.HR 132 bpm, BP 65/30 mmHg, SpO2 90%
27The patient was transferred to the post-anesthesia care unit. 
28Additional adrenaline 0.3 mg was administered. 
37A saline solution was rapidly infused, and hydrocortisone 100 mg was intravenously administered. Spontaneous respiration was assisted with 5 cm H2O CPAP at an FiO2 of 0.5.HR 125 bpm, BP 76/47 mmHg, SpO2 94%, PaO2 197 mmHg PaCO2 49 mmHg, BE 0.9 mmol/L
42Light systemic skin rashes were observed on the patient’s body. 
57Blood samples were collected to measure plasma histamine and serum tryptase levels.Histamine 271.7 nmol/L, tryptase 174 μg/L
77The patient’s trachea was extubated.HR 110 mmHg, BP 103/44 mmHg, SpO2 99%
  1. HR heart rate, BP blood pressure, SpO2 peripheral blood oxygen saturation