{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T14:06:17Z","timestamp":1775570777367,"version":"3.50.1"},"reference-count":0,"publisher":"Journal of Nepal Medical Association (JNMA)","issue":"293","license":[{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Nepal Med Assoc"],"abstract":"<jats:p>Perioperative anaphylaxis (POA) is a rare but potentially fatal event, with an incidence ranging from 1:300 to 1:20,000 surgeries and a mortality rate of 3\u20139%. Its intraoperative occurrence is diagnostically challenging due to patient sedation and overlapping drug effects. Crystalloids like Ringer\u2019s Lactate (RL) are rarely implicated. A 27-year-old American Society of Anesthesiologists grade I female undergoing mastoidectomy developed intraoperative hypotension, tachycardia, and generalized erythema after induction with standard anesthetics and Ringer\u2019s Lactate infusion. Anaphylaxis was suspected, and Ringer\u2019Lactate was discontinued. The patient improved rapidly upon switching to normal saline. A subcutaneous challenge postoperatively confirmed Ringer\u2019s Lactate as the trigger. This case highlights an uncommon but serious hypersensitivity to Ringer\u2019s Lactate. Clinicians must maintain high suspicion for all agents, including crystalloids, during Perioperative anaphylaxis. Prompt recognition, discontinuation of the offending agent, and supportive treatment are crucial. Given the widespread use of Ringer\u2019s Lactate, awareness of this rare reaction is essential to prevent misdiagnosis and ensure patient safety.<\/jats:p>","DOI":"10.31729\/jnma.v64i293.9287","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T18:05:32Z","timestamp":1767204332000},"page":"50-53","source":"Crossref","is-referenced-by-count":1,"title":["Allergy to Ringer's Lactate - Uncommon Cause of Anaphylaxis during Intraoperative Period: A Case Report"],"prefix":"10.31729","volume":"64","author":[{"given":"Shova","family":"Dangol","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Surendra","family":"Man Shrestha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prabhat","family":"Rawal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nitendra","family":"Raj Bajracharya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kundan","family":"Shrestha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saurav","family":"Shrestha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pushkar","family":"B.K","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rabi","family":"Paudel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"16919","published-online":{"date-parts":[[2025,12,31]]},"container-title":["Journal of Nepal Medical Association"],"original-title":[],"link":[{"URL":"https:\/\/jnma.com.np\/jnma\/index.php\/jnma\/article\/download\/9287\/5696","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/jnma.com.np\/jnma\/index.php\/jnma\/article\/download\/9287\/5696","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T18:19:18Z","timestamp":1769105958000},"score":1,"resource":{"primary":{"URL":"https:\/\/jnma.com.np\/jnma\/index.php\/jnma\/article\/view\/9287"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,31]]},"references-count":0,"journal-issue":{"issue":"293","published-online":{"date-parts":[[2025,12,31]]}},"URL":"https:\/\/doi.org\/10.31729\/jnma.v64i293.9287","relation":{},"ISSN":["1815-672X","0028-2715"],"issn-type":[{"value":"1815-672X","type":"electronic"},{"value":"0028-2715","type":"print"}],"subject":[],"published":{"date-parts":[[2025,12,31]]}}}