Histamine release during the induction of anesthesia with propofol in allergic patients: A comparison with the induction of anesthesia using midazolam-ketamine

Abstract

Propofol was found to show a similar incidence of histamine release during the induction of anesthesia using midazolam-ketamine, and thus was also found to be a useful induction agent against histamine release for patients with a history of allergy when hydroxizine was used as a premedication.

Asthma, Sedation, and the Podiatric Patient

“…However, bronchospastic episodes and other reactions following propofol administration have been documented [1,[4][5][6][7][8][9][10][11][12][13][14]. Previously proposed etiologies for propofol reactions include a phenomenon related to histamine release as well as a reactionary cascade secondary to various chemical compounds found in propofol [5][6][7]. While propofol is considered to be safe, newer manufacturing of propofol, as disclosed below, can compromise its safety owing to its preservative or formulation [1].…”

“…However, cardiorespiratory responses were typically seen after bolus dosing versus that of a slow infusion [1,11]. Reactions, when present, may manifest as pruritus with hives, flushing, swelling, bronchconstriction, wheezing, dyspnea, nausea, stomach cramps, hypotension, cyanosis, diaphoresis, shock, and loss of consciousness [4,6,7,10]. As a whole, exacerbations are more likely to occur in chronic asthmatic patients with reactions of a bronchoconstrictive nature more commonly seen in steroid-dependent asthmatics [4].…”

Perioperative Management of a Patient with Cold Urticaria

“…Anesthetics such as propofol and thiopental are rare causes of anaphylaxis as well (11, 12). Other agents used in the operating room that may provoke an immune response include midazolam, ketamine, chlorhexidine, colloids, protamine sulfate, and local anesthetics such as lidocaine (11).…”

Immunoglobulin E‐Mediated Hypersensitivity Reaction to Ketamine

“…The literature is conflicting when trying to determine the capacity of ketamine to cause direct mast cell degranulation and histamine release. Some studies have demonstrated mast cell histamine release with ketamine use, although one such study was in a patient group with a history of allergy (asthma, hay fever, allergic rhinitis, atopic dermatitis) . Other studies have found that ketamine inhibits mast cell exocytosis and histamine release in animal models …”