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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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
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author Uchida, Satoshi
Takekawa, Daiki
Kitayama, Masato
Hirota, Kazuyoshi
author_facet Uchida, Satoshi
Takekawa, Daiki
Kitayama, Masato
Hirota, Kazuyoshi
author_sort Uchida, Satoshi
collection PubMed
description 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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spelling pubmed-88988052022-03-15 Two cases of circulatory collapse due to suspected remimazolam anaphylaxis Uchida, Satoshi Takekawa, Daiki Kitayama, Masato Hirota, Kazuyoshi JA Clin Rep Case Report 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. Springer Berlin Heidelberg 2022-03-06 /pmc/articles/PMC8898805/ /pubmed/35249154 http://dx.doi.org/10.1186/s40981-022-00508-5 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Case Report
Uchida, Satoshi
Takekawa, Daiki
Kitayama, Masato
Hirota, Kazuyoshi
Two cases of circulatory collapse due to suspected remimazolam anaphylaxis
title Two cases of circulatory collapse due to suspected remimazolam anaphylaxis
title_full Two cases of circulatory collapse due to suspected remimazolam anaphylaxis
title_fullStr Two cases of circulatory collapse due to suspected remimazolam anaphylaxis
title_full_unstemmed Two cases of circulatory collapse due to suspected remimazolam anaphylaxis
title_short Two cases of circulatory collapse due to suspected remimazolam anaphylaxis
title_sort two cases of circulatory collapse due to suspected remimazolam anaphylaxis
topic Case Report
url 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
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