Fentanyl-associated anaphylaxis in an infant with tetralogy of Fallot: a case report.
Anaphylaxis
Fentanyl
Intradermal testing
Morphine
Remifentanil
Journal
JA clinical reports
ISSN: 2363-9024
Titre abrégé: JA Clin Rep
Pays: Germany
ID NLM: 101682121
Informations de publication
Date de publication:
21 May 2019
21 May 2019
Historique:
received:
02
04
2019
accepted:
13
05
2019
entrez:
7
2
2020
pubmed:
7
2
2020
medline:
7
2
2020
Statut:
epublish
Résumé
Anaphylactic reactions to opioids are rare. We report a case of an infant who experienced fentanyl-induced anaphylaxis. A 2-month-old male was scheduled to undergo a Blalock-Taussig shunt. Following uneventful anesthetic induction, he experienced profound hypotension and generalized erythema. Anaphylaxis was clinically diagnosed, and he was treated with epinephrine, vasopressin, and fluids. The surgery was canceled, and he was transferred to the intensive care unit after restoration of his hemodynamic status. Intradermal testing was performed for all of the drugs given during the anaphylactic event on postoperative day (POD) 3. The results showed a positive reaction to fentanyl. For the second anesthesia scheduled on POD 5, morphine sulfate was selected as an alternative opioid. Anesthesia was maintained uneventfully with sevoflurane, morphine, and rocuronium. Intradermal testing revealed fentanyl anaphylaxis. We were able to manage the patient by using of morphine as an alternative opioid for the subsequent anesthesia.
Sections du résumé
BACKGROUND
BACKGROUND
Anaphylactic reactions to opioids are rare. We report a case of an infant who experienced fentanyl-induced anaphylaxis.
CASE PRESENTATION
METHODS
A 2-month-old male was scheduled to undergo a Blalock-Taussig shunt. Following uneventful anesthetic induction, he experienced profound hypotension and generalized erythema. Anaphylaxis was clinically diagnosed, and he was treated with epinephrine, vasopressin, and fluids. The surgery was canceled, and he was transferred to the intensive care unit after restoration of his hemodynamic status. Intradermal testing was performed for all of the drugs given during the anaphylactic event on postoperative day (POD) 3. The results showed a positive reaction to fentanyl. For the second anesthesia scheduled on POD 5, morphine sulfate was selected as an alternative opioid. Anesthesia was maintained uneventfully with sevoflurane, morphine, and rocuronium.
CONCLUSION
CONCLUSIONS
Intradermal testing revealed fentanyl anaphylaxis. We were able to manage the patient by using of morphine as an alternative opioid for the subsequent anesthesia.
Identifiants
pubmed: 32026060
doi: 10.1186/s40981-019-0254-x
pii: 10.1186/s40981-019-0254-x
pmc: PMC6967027
doi:
Types de publication
Journal Article
Langues
eng
Pagination
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