Allergische und pseudoallergische Reaktionen in der Anästhesie - Teil I: Pathogenese, Risikofaktoren, Substanzen

Jl, Theissen; Zahn, Peter; Theissen, U.; Brehler, R.

doi:10.1055/s-2007-996438

Cited by 13 publications

(6 citation statements)

References 10 publications

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“…6 The prevalence of anaphylactic reaction to anesthetics is between 1:3500 and 1:20,000; estimated mortality rate amounts from 3% to 6%. 7 Fewer than 1% of the adverse reactions caused by local anesthetics are attributed to true allergy. 8 When such reactions occur, they are usually due to p-aminobenzoic acid esters of procaine or tetracaine.…”

Section: Discussionmentioning

confidence: 99%

Systemic Anaphylaxis Following Local Lidocaine Administration During a Dental Procedure

Chiu

Lin

Hsia

et al. 2004

Pediatric Emergency Care

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We report a 4-year-old child who developed systemic anaphylactic reaction to lidocaine hydrochloride within 15 minutes after a dental procedure. Hypersensitivity to local anesthetics is not common; however, if anaphylaxis did happen, it required emergent and immediate resuscitation. To prevent such complications, complete medical history including drug allergy should be taken. Prompt administration of epinephrine and other resuscitative measures are life saving in such circumstance. All emergency room physicians should consider systemic anaphylaxis in patients with rapid vascular collapse and respiratory failure immediately following lidocaine administration for minor outpatient procedures.

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Section: Discussionmentioning

confidence: 99%

Systemic Anaphylaxis Following Local Lidocaine Administration During a Dental Procedure

Chiu

Lin

Hsia

et al. 2004

Pediatric Emergency Care

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“…Allergic drug reactions are classified into two categories: immune system‐mediated and nonimmune system, direct drug reactions. Four types of immune system‐mediated reactions have been described (6–11). Type I reactions are anaphylactic or immediate hypersensitivity reactions, which require previous exposure to the antigen for sensitization to occur.…”

Section: Discussionmentioning

confidence: 99%

Severe anaphylactic shock without exanthema in a case of unknown latex allergy and review of the literature

Hollnberger

Gruber²,

Frank

2002

Pediatric Anesthesia

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We describe a case of severe anaphylactic shock without exanthema in an 8-year-old boy who was undergoing elective surgery for an ileostomy. The boy had a history of four anorectal operations in the newborn period, but no history of allergies. Sudden, profound bronchospasm and cardiorespiratory collapse occurred 30 min after the beginning of the operation. No signs of exanthema or urticaria were seen. The patient was resuscitated successfully and remained ventilated for 25 h. During this time, he needed epinephrine in dosages of 0.3-0.05 microg.kg-1.min-1. Radioallergosorbent (RAST) tests for the patient were positive Cap Class 3 and 4, and specific immunoglobulin E was highly positive, suggesting a natural rubber latex allergy as the cause of the anaphylactic shock. Ethylene oxide was negative. Eleven days later, a further operation was performed with a strict latex-free protocol in the presence of histamine 1 and 2 receptor antagonists. On this occasion, the intraoperative course was uneventful. Incidence of anaphylactic reactions, prevalence of latex sensitization, special risk groups and management are discussed.

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“…Alerjik reaksiyonun tedavisinde sorumlu antijen ile teması kesilerek mediyatör üretimi ve salgılanmasını inhibe etmek ve serbest mediyatörlerin etkilerini modüle etmek amaçlanır (6). Ayrıca yayınlanan tüm makalelerde tavsiye edildiği gibi anestezi sırasındaki hipersensitivite reaksiyonlarının tedavisinin temel taşı epinefrin ve sıvı tedavisidir.…”

Section: Olgu Sunumuunclassified

Intraoperative Ephedrine Allergy in a Patient Who Received Chemotherapy and Perioperative Hypersensitivity Reactions

Hakimoğlu¹,

Tuzcu²,

Davarcı³

et al. 2015

Turk J Anesth Reanim

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Anaesthesia represents a specific set-up in respect to pharmacology, and during this time, early hypersensitivity reactions or anaphylaxis may occur in patients who are exposed to a great number of foreign substances. Intravenous ephedrine (5 mg) was applied to a 37-yearold patient due to the development of intraoperative hypotension in a total abdominal hysterectomy operation. After application, hyperaemia was seen in the track of the intravenous catheter of that extremity. Approximately 15 minutes later, urticarial plaques were observed extensively in the abdomen and in both extremities. Methylprednisolone (100 mg+100 mg) and pheniramine (45.5 mg) were given with an increasing infusion rate of intravenous crystalloid. The patient was extubated without any problem and removed to the recovery unit for observation. After the total disappearance of lesions at postoperative 60 minutes and because of the stability of vital signs, the patient was removed to the service. In the follow-up of surgery, no complication developed, and the patient was discharged on postoperative day 2. Keywords: Ephedrine, intraoperative, hypersensitivity reactionsKemoterapi almış hastada intraoperatif efedrin alerjisi ve perioperatif hipersensitivite reaksiyonları anestezi, farmakolojik açı-dan özgül bir durumu temsil eder ve bu süre boyunca çok sayıda yabancı maddelere maruz kalan hastalarda erken aşırı duyarlılık reaksiyonları veya anafilaksi gelişebilir. Otuz yedi yaşındaki, total abdominal histerektomi planlanan hastada intraoperatif hipotansiyon gelişmesi nedeniyle (5 mg) efedrin iv uygulandı. Uygulama sonrası aynı ekstremitenin iv kanülün yerleştirildiği ven trasesi hattında kızarıklık görüldü. Yaklaşık 15 dakika sonra her iki ekstremitede, batında yaygın ürtiker plakları gözlendi. İntra-venöz kristalloid infüzyon hızı arttırılarak, metilprednisolon (100 mg+100 mg), Feniraminmaleat (45,5 mg) verildi. Postoperatif sorunsuz ekstübe edilerek postoperatif bakım ünitesinde gözleme alındı. Lezyonları postoperatif 60. dakikada tamamen ortadan kalkmasının ardından yaşamsal bulgularının da istikrarlı olması nedeniyle servise alındı. Cerrahi takibinde herhangi bir komplikasyon gelişmeyen hasta yatışının ikinci gününde taburcu edildi. 130 GirişA lerjik ilaç reaksiyonları ilaçlara bağlı tüm istenmeyen etkilerin %6-10'unu oluşturur. İlaç reaksiyonunu Dünya Alerji Organizasyonu, IgE veya T hücre aracılıklı hipersensitivite reaksiyonları ile oluşuyorsa ilaç alerjisi olarak tanımlamış-tır. İlaç alerjisi kendisini en fazla deri bulguları ile göstermektedir (1).Anestezi sırasında kullanılan ilaçlardan genel anestetikler, lokal anestetikler, kas gevşeticiler, opioidler, antibiyotikler, intravenöz sıvılardan volüm genişleticiler ve kan ürünleri gibi birçok etkene karşı duyarlı hastalarda alerjik reaksiyon görüldü-ğü bilinmektedir. Anestezi sırasında, anafilaksi ya da anafilaktoid reaksiyondan sorumlu olabilecek pek çok ilaç bir arada kullanıldığı için sorumlu ajanı saptamak güçtür. Bu ilaçlardan genel anestezi sırasında en sık kas gevşeticilere karşı a...

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Allergische und pseudoallergische Reaktionen in der Anästhesie - Teil I: Pathogenese, Risikofaktoren, Substanzen

Cited by 13 publications

References 10 publications

Systemic Anaphylaxis Following Local Lidocaine Administration During a Dental Procedure

Systemic Anaphylaxis Following Local Lidocaine Administration During a Dental Procedure

Severe anaphylactic shock without exanthema in a case of unknown latex allergy and review of the literature

Intraoperative Ephedrine Allergy in a Patient Who Received Chemotherapy and Perioperative Hypersensitivity Reactions

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