{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T16:50:38Z","timestamp":1780332638359,"version":"3.54.1"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,3,6]],"date-time":"2022-03-06T00:00:00Z","timestamp":1646524800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,3,6]],"date-time":"2022-03-06T00:00:00Z","timestamp":1646524800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["JA Clin Rep"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Remimazolam was approved in Japan in January 2020. We report two cases of circulatory collapse due to suspected remimazolam anaphylaxis during anesthetic induction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>Case 1: A 74-year-old male was scheduled for debridement and skin grafting for a severe burn injury. We induced anesthesia with 4 mg of remimazolam and 20 mg of ketamine. The patient subsequently developed treatment-resistant severe hypotension.<\/jats:p><jats:p>Case 2: A 59-year-old male was scheduled for laparoscopic-assisted sigmoid colectomy. We induced anesthesia with 9 mg of remimazolam. Within a few minutes, the patient developed treatment-resistant severe hypotension.<\/jats:p><jats:p>As serum tryptase was elevated in both cases and only intravenous administration of adrenaline was effective, we considered the circulatory collapse might be due to anaphylaxis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We experienced two cases of circulatory collapse due to suspected remimazolam anaphylaxis during anesthetic induction. The prevalence of remimazolam anaphylaxis is not yet known, and further research is needed.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s40981-022-00508-5","type":"journal-article","created":{"date-parts":[[2022,3,6]],"date-time":"2022-03-06T11:02:28Z","timestamp":1646564548000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Two cases of circulatory collapse due to suspected remimazolam anaphylaxis"],"prefix":"10.1186","volume":"8","author":[{"given":"Satoshi","family":"Uchida","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daiki","family":"Takekawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Kitayama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuyoshi","family":"Hirota","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,3,6]]},"reference":[{"key":"508_CR1","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1007\/s00540-020-02755-1","volume":"34","author":"K Masui","year":"2020","unstructured":"Masui K. Remimazolam besilate, a benzodiazepine, has been approved for general anesthesia!! J Anesth. 2020;34:479\u201382.","journal-title":"J Anesth."},{"key":"508_CR2","first-page":"543-53","volume":"34","author":"M Doi","year":"2020","unstructured":"Doi M, Morita K, Takeda J, Sakamoto A, Yamakage M, Suzuki T. Efficacy and safety of remimazolam versus propofol for general anesthesia: a multicenter, single-blind, randomized, parallel-group, phase IIb\/III trial. J Anesth. 2020;34:543-53.","journal-title":"J Anesth."},{"key":"508_CR3","first-page":"491-501","volume":"34","author":"M Doi","year":"2020","unstructured":"Doi M, Hirata N, Suzuki T, Morisaki H, Morimatsu H, Sakamoto A. Safety and efficacy of remimazolam in induction and maintenance of general anesthesia in high-risk surgical patients (ASA Class III): results of a multicenter, randomized, double-blind, parallel-group comparative trial. J Anesth. 2020;34:491-501.","journal-title":"J Anesth."},{"key":"508_CR4","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1007\/s00540-021-02934-8","volume":"35","author":"K Tsurumi","year":"2021","unstructured":"Tsurumi K, Takahashi S, Hiramoto Y, Nagumo K, Takazawa T, Kamiyama Y. Remimazolam anaphylaxis during anesthesia induction. J Anesth. 2021;35:571\u20135.","journal-title":"J Anesth."},{"key":"508_CR5","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1097\/ACI.0b013e328355b82f","volume":"12","author":"P Mertes","year":"2012","unstructured":"Mertes P, Demoly P, Malinovsky J. Hypersensitivity reactions in the anesthesia setting\/allergic reactions to anesthetics. Curr Opin Allergy Clin Immunol. 2012;12:361\u20138.","journal-title":"Curr Opin Allergy Clin Immunol"},{"key":"508_CR6","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1186\/s13223-016-0126-0","volume":"12","author":"IF Nevis","year":"2016","unstructured":"Nevis IF, Binkley K, Kabali C. Diagnostic accuracy of skin-prick testing for allergic rhinitis: a systematic review and meta-analysis. Allergy Asthma Clin Immunol. 2016;12:20.","journal-title":"Allergy Asthma Clin Immunol."},{"key":"508_CR7","doi-asserted-by":"publisher","first-page":"e50","DOI":"10.1016\/j.bja.2019.04.044","volume":"123","author":"LH Garvey","year":"2019","unstructured":"Garvey LH, Dewachter P, Hepner DL, Mertes PM, Voltolini S, Clarke R, et al. Management of suspected immediate perioperative allergic reactions: an international overview and consensus recommendations. Br J Anaesth. 2019;123:e50\u201364.","journal-title":"Br J Anaesth."},{"key":"508_CR8","doi-asserted-by":"publisher","first-page":"778","DOI":"10.1007\/s00540-021-03005-8","volume":"35","author":"T Takazawa","year":"2021","unstructured":"Takazawa T, Yamaura K, Hara T, Yorozu T, Mitsuhata H, Morimatsu H. Working Group for the Preparation of Practical Guidelines for the Response to Anaphylaxis, Safety Committee of the Japanese Society of Anesthesiologists. Practical guidelines for the response to perioperative anaphylaxis. J Anesth. 2021;35:778\u201393.","journal-title":"J Anesth."},{"key":"508_CR9","doi-asserted-by":"crossref","first-page":"1157","DOI":"10.1111\/all.13752","volume":"74","author":"J Vitte","year":"2019","unstructured":"Vitte J, Amadei L, Gouitaa M, Mezouar S, Zieleskiewicz L, Albanese J, et al. Paired acute-baseline serum tryptase levels in perioperative anaphylaxis: An observational study. Allergy. 2019;74:1157\u201365.","journal-title":"Allergy."},{"key":"508_CR10","first-page":"253","volume":"149","author":"KG Ljungstr\u00f6m","year":"1983","unstructured":"Ljungstr\u00f6m KG, Renck H, Strandberg K, Hedin H, Richter W, Widerl\u00f6v E. Adverse reactions to dextran in Sweden 1970-1979. Acta Chir Scand. 1983;149:253\u201362.","journal-title":"Acta Chir Scand."},{"key":"508_CR11","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1159\/000233080","volume":"68","author":"H Hedin","year":"1982","unstructured":"Hedin H, Richter W. Pathomechanisms of dextran-induced anaphylactoid\/anaphylactic reactions in man. Int Arch Allergy Appl Immunol. 1982;68:122\u20136.","journal-title":"Int Arch Allergy Appl Immunol."},{"key":"508_CR12","volume":"2015","author":"T Shiratori","year":"2015","unstructured":"Shiratori T, Sato A, Fukuzawa M, Kondo N, Tanno S. Severe Dextran-Induced Anaphylactic Shock during Induction of Hypertension-Hypervolemia-Hemodilution Therapy following Subarachnoid Hemorrhage. Case Rep Crit Care. 2015;2015:967560.","journal-title":"Case Rep Crit Care."},{"key":"508_CR13","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1111\/j.1365-2044.2009.05970_2.x","volume":"64","author":"NJ Harper","year":"2009","unstructured":"Harper NJ, Dixon T, Dugu\u00e9 P, Edgar DM, Fay A, Gooi HC, et al. Working Party of the Association of Anaesthetists of Great Britain and Ireland. Suspected anaphylactic reactions associated with anaesthesia. Anaesthesia. 2009;64:199\u2013211.","journal-title":"Anaesthesia."}],"container-title":["JA Clinical Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40981-022-00508-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40981-022-00508-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40981-022-00508-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,18]],"date-time":"2023-11-18T13:03:51Z","timestamp":1700312631000},"score":1,"resource":{"primary":{"URL":"https:\/\/jaclinicalreports.springeropen.com\/articles\/10.1186\/s40981-022-00508-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,6]]},"references-count":13,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["508"],"URL":"https:\/\/doi.org\/10.1186\/s40981-022-00508-5","relation":{},"ISSN":["2363-9024"],"issn-type":[{"value":"2363-9024","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,6]]},"assertion":[{"value":"20 January 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 February 2022","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 February 2022","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 March 2022","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Informed consent for scientific publication was obtained from the patients.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"18"}}