Article Data

  • Views 881
  • Dowloads 170

Original Research

Open Access

An Allergic Reaction Following Intramuscular Administration of Ketamine and Midazolam

  • Sean G. Boynes1,*,
  • Anne L. Lemak1
  • Denise M. Skradski2
  • Michael A. Cuddy1

1University of Pittsburgh School of Dental Medicine, Department of Anesthesiology

2University of Pittsburgh School of Nursing, Nurse Anesthesia Training Program

DOI: 10.17796/jcpd.31.2.6q619k3664634250 Vol.31,Issue 2,March 2007 pp.77-79

Published: 01 March 2007

*Corresponding Author(s): Sean G. Boynes E-mail: sgb-anes@comcast.net

Abstract

A 6-year-old female in good health presented with no known drug allergies for dental treatment under general anesthesia. Following the preoperative evaluation, the patient received intramuscular premedication consisting of midazolam (1 mg) and Ketamine (60 mg) into the left deltoid muscle. During patient transfer, anesthesia personnel detected a hive developing in proximity to the patient's right ear lobe. The subject was directly placed into the operative chair, and a physical exam revealed urticaria on the neck, back, and torso. In addition, an audible wheeze was detected with lung auscultation. Investigations carried out after the incident revealed a positive reaction to ketamine

Keywords

allergic reaction, anaphylactoid, anesthesiology, ketamine, pre-medication


Cite and Share

Sean G. Boynes,Anne L. Lemak,Denise M. Skradski,Michael A. Cuddy. An Allergic Reaction Following Intramuscular Administration of Ketamine and Midazolam. Journal of Clinical Pediatric Dentistry. 2007. 31(2);77-79.

References

1. Dachs RJ, Innes GM. Intravenous ketamine sedation for pediatric patients in the emergency department. Ann Emerg Med 29:146-50, 1997.

2. Marx CM, Stew J, Tyler MK, Nieder ML, Shurin SB, Blumer JL. Ketamine-midazolam versus meperadine-midazolam for painful proce dures in pediatric oncology patients. J Clin Oncol 15: 94-102, 1997

3. Roelofse JA, Joubert JJ, Roelofse PG. A double-blind randomized comparison of midazolam alone and midazolam combined with keta-mine for sedation of pediatric dental patients. J Oral Maxilofac Surg 54: 838-44, 1996.

4. Sterkhov RV,Vinogradova MS, Mixikov VM. Optimization of anesthe-siological maintenance of X-ray surgical interventions in children. Anesteziol Reanimatol 5: 55-57, 2002

5. Mason KP, Michna E, Dinardo JA, Zurakowski D, Karian VE, Connor L, Burrows PE. Evolution of a protocol for ketamine induced sedation as an alternative to general anesthesia for interventional radiologic pro-cedures in pediatric patients. Radiology 225: 457-65, 2002

6. Giovannitti JA. Dissociative Sedation. Texas Dent J 111: 25-29, 1994.

7. Bergman SA. Ketamine: Review of its pharmacology and its use in pediatric anesthesia. Anesth Prog 46: 10-20, 1999

8. White PF, Way WL, Trevor AJ. Ketamine – Its pharmacology and ther-apeutic uses. Anesthesiology 56: 119-136, 1982.

9. Cotsen MR, Donaldson JS, Uejima T, Morello FP. Efficacy of ketamine hydrochloride sedation in children for interventional radiologic proce-dures. Am J Roentgenol 169:1019-1022, 1997

10. Bourke DL, Malit LA, Smith TC. Respiratory interactions of ketamine and morphine. Anesthesiology 66:153-56, 1987.

11. Hamza J, Ecoffey C, Gross JB. Ventilatory response to CO2 following intravenous ketamine in children. Anesthesiology 70: 422-25, 1989.

12. Geisslinger G, Hering W, Thomann P, Knoll P, Kamp HD, Brune K. Pharmacokinetics and pharmacodynamics of ketamine enantiomers in surgical patients using stereoselective analytical method. Br J Anaesth. 70:666-671, 1993.

13. Jacobson JD, McGrath CJ, Smith EP. Cardiorespiratory effects if induction and maintenance of anesthesia with ketamine-midazolam combination with and without prior administration of burtorphanol or oxymorphone. Am J Vet Res. 55: 543-50, 1994.

14. Gouzoulis-Mayfrank E, Heekenen K, Neukrch A, Stoll M, Stock C, Obradovic M, Kovar KA. Psychological effects of (s)-ketamine and N, N-dimethltryptamine (DMT); A double-blind cross-over study in health volunteers. Pharmacopsychiatry 38: 301-11, 2005.

15. Green SM, Sherwin TS. Incidence and severity of recovery agitation after ketamine sedation in young adults. Am J Emerg Med. 2005; 23: 142-44.

16. Cartwright PD, Pingel SM, Midazolam and diazepam in ketamine anes thesia. Anaesthesia 59: 439-442, 1984.

17. Kumar SM, Kothary SP, Zsigmond EK. Plasma free norepinephrine and epinephrine concentration following diazepam-ketamine induction in patients undergoing cardiac surgery. Acta Anaesth Scand 22: 593-600, 1978.

18. Soltis RP, Cook JC, Gregg AE, Sanders BJ. Interaction of GABA and excitatory amino acids in the basolateral amygdalarole in cardiovascu-lar regulation. J Neurosci 17:9367-74, 1997

19. Karayan J, Lacoste L, Breuil K. [Allergy to Ketamine]. Ann Fr Anesthe Reanim 9: 396-97, 1990.

20. Matthews NS, Light GS, Sanders EA, Hartsfield SM, Hustead DR. Urticarial response during anesthesia in a horse. Equine Vet J 25: 555-56, 1993.

21. Kimura K, Adachi M, Kubo K. Histamine release during the induction of anesthesia with propofol in allergic patients: a comparison with the induction of anesthesia using midazolam-ketamine. Inflamm Res 48: 582-87, 1999.

22. Ketamine Hydrochloride Injection, USP. Package/Product Insert. 2004. Hospira, Inc. lacke Forest, IL.

23. Kimura K, Adachi M, Kubo K. H1 and H2 – receptor antagonists pre vent histamine release in allergic patients after the administration of midazolam-ketamine: A randomized, controlled study. Inflamm Res 48: 128-32, 1999

24. The Brighton Collaboration Thrombocytopenia Working Group. Anaphylaxis as adverse events following immunization: Case defini-tion and guidelines for data collection, analysis, and presentation. http://brightoncollaboration.org. [Accessed: May 18, 2006].

25. Amutike D. Clinical Dilemmas. Issue 2 (1992); Article 10.

http://www.fsm.ac.fj/sms/anaesthesia/wpsa/html/u02/u02_012.htm.

[Accessed: May 18, 2006].

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,500 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Biological Abstracts Easily discover critical journal coverage of the life sciences with Biological Abstracts, produced by the Web of Science Group, with topics ranging from botany to microbiology to pharmacology. Including BIOSIS indexing and MeSH terms, specialized indexing in Biological Abstracts helps you to discover more accurate, context-sensitive results.

Google Scholar Google Scholar is a freely accessible web search engine that indexes the full text or metadata of scholarly literature across an array of publishing formats and disciplines.

JournalSeek Genamics JournalSeek is the largest completely categorized database of freely available journal information available on the internet. The database presently contains 39226 titles. Journal information includes the description (aims and scope), journal abbreviation, journal homepage link, subject category and ISSN.

Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.

BIOSIS Previews BIOSIS Previews is an English-language, bibliographic database service, with abstracts and citation indexing. It is part of Clarivate Analytics Web of Science suite. BIOSIS Previews indexes data from 1926 to the present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Scopus: CiteScore 1.8 (2023) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Submission Turnaround Time

Conferences

Top