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Anaphylactoid-like Reaction to Midazolam During Oral and Maxillofacial Surgery
Terumi Ayuse1, Shinji Kurata2, Takao Ayuse1
1Department of Special Care Dentistry, Nagasaki University Hospital, Nagasaki, Japan.
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.
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