Anaphylaxis due to midazolam administered before induction of general anesthesia: a case report.

IF 0.8 Q3 ANESTHESIOLOGY

JA Clinical Reports Pub Date : 2025-06-19 DOI:10.1186/s40981-025-00800-0

Ryosuke Funabiki, Tatsuo Horiuchi, Toshie Shiraishi, Masaki Orihara, Kazuhiro Nagumo, Shigeru Saito

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引用次数: 0

Abstract

Background: Anaphylaxis is an immediate allergic reaction. However, in some cases, there is a delay between the administration of the causative agent and the onset of anaphylaxis.

Case presentation: A 41-year-old woman was scheduled for laparoscopic myomectomy under general anesthesia combined with epidural anesthesia. Midazolam was administered, and an epidural catheter was inserted. Seven minutes after the induction of general anesthesia (17 min after midazolam administration), the patient developed tachycardia, hypotension, and redness of the face and trunk. Her hemodynamic status improved after administration of phenylephrine and elevation of both legs, and the surgery was completed. Increased blood histamine and tryptase levels were observed 30 min after the onset of hemodynamic signs. Based on the above, anaphylaxis was diagnosed. Skin tests later showed that midazolam was the causative agent.

Conclusions: A case of perioperative anaphylaxis caused by midazolam, which was used before the induction of general anesthesia, was described.

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全麻诱导前咪达唑仑致过敏反应1例报告。

背景：过敏反应是一种即时过敏反应。然而，在某些情况下，在给药和过敏反应发生之间存在延迟。病例介绍：一名41岁女性在全麻联合硬膜外麻醉下行腹腔镜子宫肌瘤切除术。给予咪达唑仑，并插入硬膜外导管。全麻诱导后7分钟（咪达唑仑给药后17分钟），患者出现心动过速、低血压、面部和躯干发红。在给予苯肾上腺素和抬高双腿后，她的血流动力学状况有所改善，手术完成。血流动力学症状出现30分钟后观察到血组胺和胰蛋白酶水平升高。基于以上，诊断为过敏反应。后来的皮肤试验表明咪达唑仑是病原体。结论：报告了一例在全麻诱导前使用咪达唑仑引起的围手术期过敏反应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JA Clinical Reports ANESTHESIOLOGY-

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

9 weeks

期刊介绍： JA Clinical Reports is a companion journal to the Journal of Anesthesia (JA), the official journal of the Japanese Society of Anesthesiologists (JSA). This journal is an open access, peer-reviewed, online journal related to clinical anesthesia practices such as anesthesia management, pain management and intensive care. Case reports are very important articles from the viewpoint of education and the cultivation of scientific thinking in the field of anesthesia. However, submissions of anesthesia research and clinical reports from Japan are notably decreasing in major anesthesia journals. Therefore, the JSA has decided to launch a new journal, JA Clinical Reports, to encourage JSA members, particularly junior Japanese anesthesiologists, to publish papers in English language.