TY - JOUR
T1 - Patients with a history of hypersensitivity reaction to iodinated contrast medium and given iodinated contrast during an interventional pain procedure
AU - Benzon, Honorio T.
AU - Schechtman, Jeffrey
AU - Zheng, Sophy C.
AU - Katz, Jeffery A.
AU - Patel, Arpan
AU - Nagpal, Geeta
AU - Liu, Benjamin P.
N1 - Publisher Copyright:
© 2019 American Society of Regional Anesthesia & Pain Medicine.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - In patients with a history of a hypersensitivity reaction to iodinated contrast medium, iodinated contrast medium is avoided, antihistamine and steroid premedication are given, or a gadolinium-based contrast agent is employed. Six patients with a history of a hypersensitivity reaction to iodinated contrast medium and who were not premedicated had an unintentional injection of iodinated contrast. None of the patients developed a moderate or severe reaction. All patients had gadopentetate dimeglumine in one of their injections; three had repeated injections of the gadopentetate. The lack of a significant reaction may be due to any or all of the following: questionable history of iodinated contrast reaction, low dose of iodinated contrast given, concomitant injection of (epidural) steroid, and slower absorption from epidural compared with intravenous injection. While it is reassuring to know that there is a low possibility of a moderate to severe reaction in these patients, every effort should be made to avoid this scenario, appropriate drugs and resuscitation equipment should be immediately available, and the patients should be observed adequately and followed for the possibility of late reactions. Recent publications have called for caution in the use of gadolinium-based contrast agents.
AB - In patients with a history of a hypersensitivity reaction to iodinated contrast medium, iodinated contrast medium is avoided, antihistamine and steroid premedication are given, or a gadolinium-based contrast agent is employed. Six patients with a history of a hypersensitivity reaction to iodinated contrast medium and who were not premedicated had an unintentional injection of iodinated contrast. None of the patients developed a moderate or severe reaction. All patients had gadopentetate dimeglumine in one of their injections; three had repeated injections of the gadopentetate. The lack of a significant reaction may be due to any or all of the following: questionable history of iodinated contrast reaction, low dose of iodinated contrast given, concomitant injection of (epidural) steroid, and slower absorption from epidural compared with intravenous injection. While it is reassuring to know that there is a low possibility of a moderate to severe reaction in these patients, every effort should be made to avoid this scenario, appropriate drugs and resuscitation equipment should be immediately available, and the patients should be observed adequately and followed for the possibility of late reactions. Recent publications have called for caution in the use of gadolinium-based contrast agents.
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U2 - 10.1136/rapm-2018-000012
DO - 10.1136/rapm-2018-000012
M3 - Article
C2 - 30640663
AN - SCOPUS:85060035683
SN - 1098-7339
VL - 44
SP - 118
EP - 121
JO - Regional anesthesia and pain medicine
JF - Regional anesthesia and pain medicine
IS - 1
ER -