A "Rash" Decision in Anesthetic Management: Benzyl Alcohol Allergy in the Perioperative Period.
Citation: Case Reports in Anesthesiology. 2021:8859823, 2021.PMID: 34258071Institution: MedStar Washington Hospital CenterDepartment: Anesthesiology ResidencyForm of publication: Journal ArticleMedline article type(s): Case ReportsSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2021Abstract: Here, we present the case of a 54-year-old female presenting for outpatient ankle hardware removal who experienced severe total body pruritus along with a maculopapular rash persisting four days after the procedure. Patch testing demonstrated a sensitivity to benzyl alcohol, a preservative in propofol and several other anesthetics. The patient returned for left ankle arthroscopy a year later, and during that procedure, the anesthetic team avoided medications containing benzyl alcohol. This resulted in no pruritus or rash. Hypersensitivity reactions, ranging from contact dermatitis to anaphylaxis, are critical events in the perioperative period. Induction of general anesthesia has been implicated as the inciting event for perioperative hypersensitivity reactions. Benzyl alcohol is among a few excipients found in common anesthetic agents known to cause hypersensitivity reactions in susceptible patients. While reports of adult death are rare, infantile death due to benzyl alcohol has been described. Copyright (c) 2021 Michael Tripp et al.Fiscal year: FY2021Digital Object Identifier: Date added to catalog: 2021-07-26| Item type | Current library | Collection | Call number | Status | Date due | Barcode |
|---|---|---|---|---|---|---|
| Journal Article | MedStar Authors Catalog | Article | 34258071 | Available | 34258071 |
Here, we present the case of a 54-year-old female presenting for outpatient ankle hardware removal who experienced severe total body pruritus along with a maculopapular rash persisting four days after the procedure. Patch testing demonstrated a sensitivity to benzyl alcohol, a preservative in propofol and several other anesthetics. The patient returned for left ankle arthroscopy a year later, and during that procedure, the anesthetic team avoided medications containing benzyl alcohol. This resulted in no pruritus or rash. Hypersensitivity reactions, ranging from contact dermatitis to anaphylaxis, are critical events in the perioperative period. Induction of general anesthesia has been implicated as the inciting event for perioperative hypersensitivity reactions. Benzyl alcohol is among a few excipients found in common anesthetic agents known to cause hypersensitivity reactions in susceptible patients. While reports of adult death are rare, infantile death due to benzyl alcohol has been described. Copyright (c) 2021 Michael Tripp et al.
English