An allergic reaction following intramuscular administration of ketamine and midazolam.
A 6-year-old female in good health presented with no known drug allergies for dental treatment under general anesthesia. Following the preoperative evaluation, the patient received intramuscular premedication consisting of midazolam (1 mg) and Ketamine (60 mg) into the left deltoid muscle. During patient transfer, anesthesia personnel detected a hive developing in proximity to the patient's right ear lobe. The subject was directly placed into the operative chair, and a physical exam revealed urticaria on the neck, back, and torso. In addition, an audible wheeze was detected with lung auscultation. Investigations carried out after the incident revealed a positive reaction to ketamine
Boynes
Sean G
SG
University of Pittsburgh School of Dental Medicine, Department of Anesthesiology, PA 15216, USA. sgb-anes@comcast.net
Lemak
Anne L
AL
Skradski
Denise M
DM
Cuddy
Michael A
MA
D000778:Anesthetics, Dissociative / Q000008:administration & dosage / Q000009:adverse effects*; D002648:Child; D003875:Drug Eruptions / Q000209:etiology; D004342:Drug Hypersensitivity / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects*; D007273:Injections, Intramuscular; D007649:Ketamine / Q000008:administration & dosage / Q000009:adverse effects*; D008874:Midazolam / Q000008:administration & dosage / Q000009:adverse effects*; D011229:Preanesthetic Medication / Q000009:adverse effects; D012135:Respiratory Sounds / Q000187:drug effects; D014581:Urticaria / Q000139:chemically induced
D000778:Anesthetics, Dissociative; D006993:Hypnotics and Sedatives; D007649:Ketamine; D008874:Midazolam