{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T05:04:22Z","timestamp":1789103062771,"version":"build-2803163510"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:p>To avoid inhalational anesthetics, total intravenous anesthesia (TIVA) is required in patients with a predisposition to malignant hyperthermia (MH). However, propofol, which is frequently used, may be avoided in patients with egg allergies because of the contraindications in the drug information. Furthermore, some patients may not consent to the use of propofol. We report a case of TIVA using midazolam and dexmedetomidine as substitutes for propofol in a pediatric patient with egg allergy and a predisposition to MH. A 10-year-old boy was scheduled to undergo perforated drainage of an epidural abscess. He had egg allergy, and his uncle had been diagnosed with MH. He also developed a generalized drug eruption caused by antibiotics. Concerned about allergic reactions, he and his parents did not consent to administrating propofol. The patient\u2019s perioperative course was uneventful. The combination of midazolam and dexmedetomidine may be a useful option as substitutes for propofol.<\/jats:p>","DOI":"10.4103\/sja.sja_210_24","type":"journal-article","created":{"date-parts":[[2024,10,2]],"date-time":"2024-10-02T12:01:06Z","timestamp":1727870466000},"page":"573-575","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Total intravenous anesthesia using midazolam and dexmedetomidine as substitutes for propofol in a pediatric patient with egg allergy and a family history of malignant hyperthermia"],"prefix":"10.4103","volume":"18","author":[{"given":"Masashi","family":"Inoue","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Anjo Kosei Hospital, 28-Higashihirokute, Anjo-Cho, Anjo-City, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Morita","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Anjo Kosei Hospital, 28-Higashihirokute, Anjo-Cho, Anjo-City, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,10,2]]},"reference":[{"key":"R1-20260427","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1186\/s13023-015-0310-1","article-title":"Malignant hyperthermia: A review","volume":"10","author":"Rosenberg","year":"2015","journal-title":"Orphanet J Rare Dis"},{"key":"R2-20260427","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1213\/ANE.0b013e31821b450f","article-title":"Allergic reactions to propofol in egg-allergic children","volume":"113","author":"Murphy","year":"2011","journal-title":"Anesth Analg"},{"key":"R3-20260427","doi-asserted-by":"crossref","first-page":"1252","DOI":"10.1111\/anae.14693","article-title":"Propofol use in children with allergies to egg, peanut, soybean or other legumes","volume":"74","author":"Sommerfield","year":"2019","journal-title":"Anaesthesia"},{"key":"R4-20260427","first-page":"156","article-title":"Does propofol have advantages over midazolam and isoflurane? 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