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Midazolam anaphylaxis during general anesthesia: A case report

Yeon Su Jeon1, JinWoo Shim, Eun Hwa Jun

  • 1Department of Anesthesiology and Pain Medicine, St's Vincent Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Medicine
|October 9, 2019
PubMed
Abstract

Insights

Midazolam, a common sedative, can rarely cause anaphylaxis, a severe allergic reaction. This case highlights the importance of recognizing and preparing for midazolam-induced anaphylaxis during anesthesia.

Area of Science:

  • Anesthesiology
  • Allergy and Immunology

Background:

  • Midazolam is widely used as a sedative and anesthetic adjuvant, generally considered safe.
  • Awareness of midazolam's potential to cause anaphylaxis is limited due to its rarity.
  • This study reports a case of midazolam-induced anaphylaxis during general anesthesia.

Observation:

  • A 62-year-old woman developed sudden severe hypotension, bronchospasm, decreased oxygen saturation, erythema, and diarrhea after intravenous midazolam administration.
  • The patient was in the prone position under general anesthesia at the time of the reaction.

Findings:

  • Midazolam anaphylaxis was initially diagnosed based on clinical presentation.
  • Confirmation was achieved through an intradermal test conducted nine weeks post-event.
  • The patient's severe symptoms resolved rapidly with prompt medical intervention.

Implications:

  • Midazolam anaphylaxis, though rare, is a potential risk that must be considered.
  • Healthcare providers should be prepared to manage anaphylactic reactions to midazolam.
  • Early recognition and treatment are crucial for favorable patient outcomes.

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