title: 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.affiliation: Department of Special Care Dentistry, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Terumi
authors.initials: T
authors.lastname: Ayuse
authors.affiliation: Department of Dental Anesthesiology, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Kurata
authors.affiliation: Department of Special Care Dentistry, Nagasaki University Hospital, Nagasaki, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Ayuse
mesh_terms: D000707:Anaphylaxis / Q000139:chemically induced*; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D001982:Bronchial Diseases / Q000139:chemically induced; D003251:Constriction, Pathologic / Q000139:chemically induced; D004342:Drug Hypersensitivity / Q000209:etiology; D004487:Edema / Q000139:chemically induced; D005260:Female; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects*; D007022:Hypotension / Q000139:chemically induced; D008339:Mandibular Neoplasms / Q000601:surgery*; D008738:Methyl Ethers / Q000008:administration & dosage; D008874:Midazolam / Q000009:adverse effects*; D008875:Middle Aged; D009609:Nitrous Oxide / Q000008:administration & dosage; D010100:Oxygen / Q000008:administration & dosage; D000077149:Sevoflurane
chemical_list: D018685:Anesthetics, Inhalation; D006634:Histamine H1 Antagonists; D006635:Histamine H2 Antagonists; D006993:Hypnotics and Sedatives; D008738:Methyl Ethers; D000077149:Sevoflurane; D009609:Nitrous Oxide; D008874:Midazolam; D010100:Oxygen
keywords: Anaphylactoid reaction; Midazolam