Case Reports in Anesthesiology / 2023 / Article / Tab 1 / Case Report
Delayed Anaphylactic Reaction to Midazolam in the Absence of Immediate Respiratory or Skin Manifestations Table 1 The current together with previously reported anaphylactic perioperative reactions involving midazolam.
Author Age Sex Wt (kg) Surgery Midazolam mg Prior exposure Onset of symptoms (min) Epinephrine (mg) H2 blockers Steroids Flumazenil (mg) Erythema Tryptase (μ g/L) Skin testing Winegarner et al. 73 M 80 Hydrocelectomy 2 Yes 42 0.5 No No No No 56.5 Yes Nucera et al. [4 ] 54 M NA Cholecystectomy 2 NA “Few minutes” 2 No No No No NA Yes Jeon et al. [5 ] 62 F 46 Discectomy 1 Yes 1 0.1 Ranitidine 100 mg Dexamethasone 5 mg 0.25 Yes NA Yes Methylprednisolone 125 mg Çakmakcı et al. [6 ] 17 M 73 Bone marrow aspiration 5 Yes 5 0.5 No Methylprednisolone 40 mg No Yes NA NA Landsem et al. [7 ] 17 M 87 EP ablation 2 No 10 “Yes” No NA No Yes 31.7 Yes Bernardini et al. [8 ] 7 M NA Adenoidectomy 0.5 (PO) No Immediate No No Betamethasone 4 mg No No NA Yes Kim et al. [9 ] 59 M 68 Ankle ORIF 3 (IM) Yes 30 0.5 Pheniramine 40 mg Methylprednisolone 250 mg No Yes 29.9 Yes Hydrocortisone 100 mg Shin et al. [10 ] 53 F 60 EGD 5 NA 5 1 NA Dexamethasone 5 mg 0.5 Yes 14.8 No Ayuse et al. [11 ] 59 F 56 Mandible tumor resection 5 NA Immediate 0.05 No Methylprednisolone 1000 mg No Yes NA NA Shrivastava [12 ] 37 M 68 Elbow surgery 2 No 2 0.1 Ranitidine 150 mg Hydrocortisone 200 mg No Yes 3 Yes George and Williams [13 ] 23 M 53 Lymph node biopsy 1 NA 2 0.05 Ranitidine 150 mg Hydrocortisone 100 mg No Yes 2 Yes Hwang et al. [14 ] 39 M 65 Endoscopic pansinus 2 NA Immediate No NA NA No No NA Yes Uchimura et al. [15 ] 26 F NA NA 2 NA 15 Yes NA NA No Yes NA NA Fujita et al. [16 ] 38 M NA Cervical fusion 10 NA Immediate 0.05 NA Methylprednisolone 1000 mg No Yes NA No
EP, electrophysiology; EGD, esophagogastroduodenoscopy; ORIF, open reduction and internal fixation; PO, per orally; IM, intermuscular; NA, not specified in the article; doses are specified in the table if they were provided in their respective reports. Allergy testing performed weeks after discharge. Normal range of tryptase is 0-11 μ g/L.
