Anaphylactoid-like Reaction to Midazolam During Oral and Maxillofacial Surgery.

Abstract

We experienced a case of life-threatening hypotension and bronchoconstriction associated with edema in a patient undergoing resection of a tumor of the right mandible following intravenous midazolam for induction of general anesthesia. We decided to postpone surgery for further examination of a possible drug-induced allergic reaction, and we rescheduled surgery for 1 week later. After administering H1 and H2 histamine antagonists, we administered a slow induction with sevoflurane in nitrous oxide and oxygen plus intravenous atropine sulfate after performing a test dose injection. We safely induced and maintained anesthesia with nitrous oxide, oxygen, and sevoflurane.

• Authors: Terumi Ayuse, Shinji Kurata, Takao Ayuse
• Journal: Anesthesia progress (Anesth Prog) Vol. 62 Issue 2 Pg. 64-5 ( 2015) ISSN: 0003-3006 [Print] United States
• PMID: 26061575 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anesthetics, Inhalation
• Histamine H1 Antagonists
• Histamine H2 Antagonists
• Hypnotics and Sedatives
• Methyl Ethers
• Sevoflurane
• Nitrous Oxide
• Midazolam
• Oxygen

Topics

• Anaphylaxis (chemically induced)
• Anesthetics, Inhalation (administration & dosage)
• Bronchial Diseases (chemically induced)
• Constriction, Pathologic (chemically induced)
• Drug Hypersensitivity (etiology)
• Edema (chemically induced)
• Female
• Histamine H1 Antagonists (therapeutic use)
• Histamine H2 Antagonists (therapeutic use)
• Humans
• Hypnotics and Sedatives (adverse effects)
• Hypotension (chemically induced)
• Mandibular Neoplasms (surgery)
• Methyl Ethers (administration & dosage)
• Midazolam (adverse effects)
• Middle Aged
• Nitrous Oxide (administration & dosage)
• Oxygen (administration & dosage)
• Sevoflurane