Delayed Anaphylactic Reaction to Midazolam in the Absence of Immediate Respiratory or Skin Manifestations
Anaphylaxis, a type 1 hypersensitivity reaction, is a feared but uncommon complication of medications administered in the perioperative period. The incidence of perioperative hypersensitivity reactions has been reported to range from 1 in 20,000 to 1 in 1,361. Anesthesiologists are well aware of com...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-01-01
|
| Series: | Case Reports in Anesthesiology |
| Online Access: | http://dx.doi.org/10.1155/2023/3873076 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849698133265612800 |
|---|---|
| author | Andrew Winegarner Mark C. Kendall Mekhala Stephen Afreen Siddiqui |
| author_facet | Andrew Winegarner Mark C. Kendall Mekhala Stephen Afreen Siddiqui |
| author_sort | Andrew Winegarner |
| collection | DOAJ |
| description | Anaphylaxis, a type 1 hypersensitivity reaction, is a feared but uncommon complication of medications administered in the perioperative period. The incidence of perioperative hypersensitivity reactions has been reported to range from 1 in 20,000 to 1 in 1,361. Anesthesiologists are well aware of common causes of hypersensitivity such as paralytics and antibiotics; however, less common triggers of anaphylaxis need to be considered as well. Midazolam, a short acting benzodiazepine metabolized by cytochrome P450 enzymes, is considered very safe with a minimal risk profile. Previous reports have described adverse reactions to occur within seconds to minutes following the administration of midazolam. We describe a patient with no known history of asthma or allergies who underwent elective hydrocelectomy with spinal analgesia without incident until 42 minutes later at the conclusion of the procedure, when they experienced circulatory collapse necessitating immediate emergency treatment. This case emphasizes the necessity to improve knowledge and awareness of delayed hypersensitivity reactions following the administration of perioperative medications such as midazolam. |
| format | Article |
| id | doaj-art-a4731435e32d4fe6aa3c05abe6a6d7bd |
| institution | DOAJ |
| issn | 2090-6390 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Anesthesiology |
| spelling | doaj-art-a4731435e32d4fe6aa3c05abe6a6d7bd2025-08-20T03:18:59ZengWileyCase Reports in Anesthesiology2090-63902023-01-01202310.1155/2023/3873076Delayed Anaphylactic Reaction to Midazolam in the Absence of Immediate Respiratory or Skin ManifestationsAndrew Winegarner0Mark C. Kendall1Mekhala Stephen2Afreen Siddiqui3Department of AnesthesiologyDepartment of AnesthesiologyDepartment of Interventional Pain Management and AnesthesiaDepartment of Interventional Pain Management and AnesthesiaAnaphylaxis, a type 1 hypersensitivity reaction, is a feared but uncommon complication of medications administered in the perioperative period. The incidence of perioperative hypersensitivity reactions has been reported to range from 1 in 20,000 to 1 in 1,361. Anesthesiologists are well aware of common causes of hypersensitivity such as paralytics and antibiotics; however, less common triggers of anaphylaxis need to be considered as well. Midazolam, a short acting benzodiazepine metabolized by cytochrome P450 enzymes, is considered very safe with a minimal risk profile. Previous reports have described adverse reactions to occur within seconds to minutes following the administration of midazolam. We describe a patient with no known history of asthma or allergies who underwent elective hydrocelectomy with spinal analgesia without incident until 42 minutes later at the conclusion of the procedure, when they experienced circulatory collapse necessitating immediate emergency treatment. This case emphasizes the necessity to improve knowledge and awareness of delayed hypersensitivity reactions following the administration of perioperative medications such as midazolam.http://dx.doi.org/10.1155/2023/3873076 |
| spellingShingle | Andrew Winegarner Mark C. Kendall Mekhala Stephen Afreen Siddiqui Delayed Anaphylactic Reaction to Midazolam in the Absence of Immediate Respiratory or Skin Manifestations Case Reports in Anesthesiology |
| title | Delayed Anaphylactic Reaction to Midazolam in the Absence of Immediate Respiratory or Skin Manifestations |
| title_full | Delayed Anaphylactic Reaction to Midazolam in the Absence of Immediate Respiratory or Skin Manifestations |
| title_fullStr | Delayed Anaphylactic Reaction to Midazolam in the Absence of Immediate Respiratory or Skin Manifestations |
| title_full_unstemmed | Delayed Anaphylactic Reaction to Midazolam in the Absence of Immediate Respiratory or Skin Manifestations |
| title_short | Delayed Anaphylactic Reaction to Midazolam in the Absence of Immediate Respiratory or Skin Manifestations |
| title_sort | delayed anaphylactic reaction to midazolam in the absence of immediate respiratory or skin manifestations |
| url | http://dx.doi.org/10.1155/2023/3873076 |
| work_keys_str_mv | AT andrewwinegarner delayedanaphylacticreactiontomidazolamintheabsenceofimmediaterespiratoryorskinmanifestations AT markckendall delayedanaphylacticreactiontomidazolamintheabsenceofimmediaterespiratoryorskinmanifestations AT mekhalastephen delayedanaphylacticreactiontomidazolamintheabsenceofimmediaterespiratoryorskinmanifestations AT afreensiddiqui delayedanaphylacticreactiontomidazolamintheabsenceofimmediaterespiratoryorskinmanifestations |