CASE REPORT

COMBINE MIDAZOLAM-FENTANYL-KETAMIN FOR EVISERATION SURGERY IN PATIENT WITH MULTIDRUG ALERGY IN ACUTE ON CHRONIC EXCACERBATION OF HIPERSENSITIVITY REACTION

Putu Agus Surya Panji, Ida Bagus Gde Sudjana, I Wayan Suranadi, Aninda Tanggono

Putu Agus Surya Panji
Department of Anesthesiology, Intensive Care and Pain Management Medical Faculty of Udayana University Bali, Indonesia

Ida Bagus Gde Sudjana
Department of Anesthesiology, Intensive Care and Pain Management Medical Faculty of Udayana University Bali, Indonesia

I Wayan Suranadi
Department of Anesthesiology, Intensive Care and Pain Management Medical Faculty of Udayana University Bali, Indonesia

Aninda Tanggono
Department of Anesthesiology, Intensive Care and Pain Management Medical Faculty of Udayana University Bali, Indonesia. Email: anindatanggono@gmail.com
Online First: June 05, 2018 | Cite this Article
Panji, P., Sudjana, I., Suranadi, I., Tanggono, A. 2018. COMBINE MIDAZOLAM-FENTANYL-KETAMIN FOR EVISERATION SURGERY IN PATIENT WITH MULTIDRUG ALERGY IN ACUTE ON CHRONIC EXCACERBATION OF HIPERSENSITIVITY REACTION. Bali Journal of Anesthesiology 2(2): 37-40. DOI:10.15562/bjoa.v2i2.35


ABSTRACT

Multidrug Alergy is a relatively rare imunology abnormality. Generally, it caused by congenital genotype and influence with environment. After treated the acute on chronic exacerbation of hypersensivity tipe 1, and the inflamation can alleviate, the patient schedule of eviseration oculi dextra with general anesthesia. And the opthamologist curious about the proceddure because eviseration need antibiotic to wash the oculi, but there are no antibiotic saved for the patient. For general anesthesia, the patient has no history so we can’t predicted about the anesthetic drug’s allergy. We choose combine ketamine-midazolamadn fentanyl to facilitate the anesthesia. Ketamine significantly reduces the production of inflammatory cytokines without affecting the production of anti-inflammatory cytokines. Fentanyl is the opioid which is the most rarely caused allergy and have strong potential. Midazolam can help the sedation

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