Two cases of circulatory collapse due to suspected remimazolam anaphylaxis

BACKGROUND: Remimazolam was approved in Japan in January 2020. We report two cases of circulatory collapse due to suspected remimazolam anaphylaxis during anesthetic induction. CASE PRESENTATION: Case 1: A 74-year-old male was scheduled for debridement and skin grafting for a severe burn injury. We...

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Detalles Bibliográficos
Autores principales: Uchida, Satoshi, Takekawa, Daiki, Kitayama, Masato, Hirota, Kazuyoshi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2022
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8898805/
https://www.ncbi.nlm.nih.gov/pubmed/35249154
http://dx.doi.org/10.1186/s40981-022-00508-5
Descripción
Sumario:BACKGROUND: Remimazolam was approved in Japan in January 2020. We report two cases of circulatory collapse due to suspected remimazolam anaphylaxis during anesthetic induction. CASE PRESENTATION: Case 1: A 74-year-old male was scheduled for debridement and skin grafting for a severe burn injury. We induced anesthesia with 4 mg of remimazolam and 20 mg of ketamine. The patient subsequently developed treatment-resistant severe hypotension. Case 2: A 59-year-old male was scheduled for laparoscopic-assisted sigmoid colectomy. We induced anesthesia with 9 mg of remimazolam. Within a few minutes, the patient developed treatment-resistant severe hypotension. As serum tryptase was elevated in both cases and only intravenous administration of adrenaline was effective, we considered the circulatory collapse might be due to anaphylaxis. CONCLUSION: We experienced two cases of circulatory collapse due to suspected remimazolam anaphylaxis during anesthetic induction. The prevalence of remimazolam anaphylaxis is not yet known, and further research is needed.

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