病例报道 | 瑞马唑仑致过敏性喉水肿

瑞马唑仑致过敏反应后的喉水肿：一例罕见的临床表现

背景：

瑞马唑仑是一种超短效静脉注射苯二氮卓类药物，在手术镇静和麻醉中用作镇静剂/麻醉剂。

尽管最近有报道称瑞马唑仑引起的围手术期过敏反应，但过敏反应的表现仍不完全清楚。

病例介绍：

我们描述了一例在镇静状态下接受结肠镜检查的男性患者在应用瑞马唑仑后出现过敏反应的病例。

患者表现出复杂的临床症状，包括气道变化、皮肤症状、胃肠道表现和血液动力学波动。

与其他报道的病例不同，喉水肿是瑞马唑仑过敏反应的最初和主要临床特征。

结论：

瑞马唑仑引起的过敏反应发病迅速，临床特征复杂。

这个案例提醒麻醉科医生要特别警惕新型麻醉剂未知的不良反应。

关键词：

过敏性；瑞马唑仑；镇静。

原文摘要

Laryngeal edema following remimazolam-induced anaphylaxis: 

a rare clinical manifestation

Background: 

Remimazolam is an ultra-short-acting intravenous benzodiazepine, which has been used as sedative/anesthetic in procedural sedation and anesthesia. Although peri-operative anaphylaxis due to remimazolam has been reported recently, the spectrum of the allergic reactions is still not fully known.

Case presentation: 

We describe a case of anaphylaxis following remimazolam administration in a male patient undergoing colonoscopy under procedural sedation. The patient presented complex clinical signs including airway changes, skin symptoms, gastrointestinal manifestations and hemodynamic fluctuations. Different from other reported cases, laryngeal edema was the initial and main clinical feature of remimiazolam-induced anaphylaxis.

Conclusions: 

Remimazolam-induced anaphylaxis has a rapid onset and complex clinical features. This case reminds anesthesiologists should be particularly alert to the unknown adverse reactions of new anesthetics.

Keywords: Anaphylaxis; Remimazolam; Sedation.

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