Autumn Smith, Peni Daly, Maisie Jackson
A 39-year-old man with severe subglottic stenosis required jet ventilation and total intravenous anesthesia for high-risk airway surgery. However, the patient reported a propofol allergy characterized by facial and tongue swelling, raising concern for prior anaphylaxis. Because alternative anesthetic techniques were considered suboptimal, Allergy and Immunology performed skin prick and intradermal testing to propofol, both of which were negative. Following an intraoperative test dose, propofol-based total intravenous anesthesia (TIVA) was administered safely without complication. This case highlights the importance of systematic evaluation of reported anesthetic allergies in facilitating optimal perioperative management in patients undergoing complex surgeries.