Anaphylactic and anaphylactoid reactions due to anesthetic agents

Schatz, Michael; Fung, Daniel

doi:10.1007/bf02991110

Cited by 51 publications

(4 citation statements)

References 57 publications

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“…During anesthesia and surgery, allergic reactions to LAs, particularly anaphylaxis, can be life-threatening. However, numerous studies support the extremely low incidence of IgE-mediated allergic reactions, which are thought to be responsible for less than 1% of all reported reactions [ 58 , 84 , 85 ]. Kvisselgaard et al claim that various nonallergic mechanisms are usually the main cause of adverse drug reactions to Las [ 86 ].…”

Section: Discussionmentioning

confidence: 99%

Analysis of Allergy and Hypersensitivity Reactions to COVID-19 Vaccines According to the EudraVigilance Database

Romantowski,

Nazar,

Bojahr

et al. 2024

Life

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Background: The coronavirus disease 2019 (COVID-19) pandemic presented a new challenge in modern medicine: the development of vaccines was followed by massive population vaccinations. A few reports on post-vaccination allergic reactions have made patients and medical personnel uneasy as to COVID-19 vaccines’ allergic potential. Most of the studies in this area to date have been small, and some that were based on global databases skipped most of the allergic diseases and concentrated only on anaphylaxis. We aimed to analyze the incidence of serious allergic reactions based on the EudraVigilance (EV) database, regardless of the reported symptoms and allergy mechanism. Methods: The total number of administrated vaccine doses was extracted on 5 October 2023 from Vaccine Tracker and included all administrations since vaccinations began in the European Economic Area (EEA). Data on serious allergic reactions to COVID-19 vaccines were extracted from the EudraVigilance database with the same time point. The code names of 147 allergic symptoms or diseases were used. Results: The frequency of serious allergic reactions per 100,000 administered vaccine doses was 1.53 for Comirnaty, 2.16 for Spikevax, 88.6 for Vaxzevria, 2.11 for Janssen, 7.9 for Novavax, 13.3 for VidPrevtyn Beta, and 3.1 for Valneva. The most prevalent reported reactions were edema (0.46) and anaphylaxis (0.40). Only 6% of these reactions were delayed hypersensitivity-oriented. Conclusions: The overall frequency of potential serious allergic reactions to COVID-19 is very rare. Therefore, COVID-19 vaccines seem to be safe for human use. The lowest frequency of allergic reaction was observed for Comirnaty and the highest for Vaxzevria.

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Section: Discussionmentioning

confidence: 99%

Analysis of Allergy and Hypersensitivity Reactions to COVID-19 Vaccines According to the EudraVigilance Database

Romantowski,

Nazar,

Bojahr

et al. 2024

Life

View full text Add to dashboard Cite

show abstract

“…During anaesthesia and surgery, allergic reactions to LAs, particularly anaphylaxis, can be life-threatening. However, numerous studies support the extremely low incidence of IgE-mediated allergic reactions, which are thought to be responsible for less than 1% of all reported reactions (54,81,82). Kvisselgaard et al claim that various nonallergic mechanisms are usually the main cause of adverse drug reactions to Las (83).…”

Section: Discussionmentioning

confidence: 99%

Analysis of allergy and hypersensitivity reactions to COVID-19 vaccines according to the EudraVigilance database

Romantowski,

Nazar,

Bojahr

et al. 2024

Preprint

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Background: The Coronavirus Disease 2019 (COVID-19) pandemic presented a new challenge in modern medicine. The development of vaccines was followed by massive population vaccinations. A few reports on post-vaccination allergic reactions have made patients and medical personnel uneasy as to anti-COVID-19 vaccines’ allergising potential. Most of the studies in this area to date have been small, and some that were based on global databases skipped most of the allergic diseases and concentrated only on anaphylaxis. We aimed to analyse the incidence of serious allergic reactions based on the EudraVigilance (EV) database, regardless of the reported symptoms and allergy mechanism. Methods: The total number of administrated vaccine doses was extracted on the 5th October 2023 from Vaccine Tracker and included all administrations since vaccinations began in the European Economic Area (EEA). Data on serious allergic reactions to COVID-19 vaccines was extracted from the EudraVigilance database with the same time point. The code names of 147 allergic symptoms or diseases were used. Results: The frequency of serious allergic reactions per 100,000 administered vaccine doses was 1.53 for Comirnaty, 2.16 for Spikevax, 88.6 for Vaxzevria, 2.11 for Janssen, 7.9 for Novavax, 13.3 for VidPrevtyn Beta and 3.1 for Valneva. The most prevalent reported reactions were oedema (0.46) and anaphylaxis (0.40). Only 6% of these reactions were delayed hypersensitivity-oriented. Conclusions: The overall frequency of potential serious allergic reactions to COVID-19 is very rare. Therefore, COVID-19 vaccines seem to be safe for human use. The lowest frequency of allergic reaction was observed for Comirnaty and the highest for Vaxzevria.

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“…The current study suggests that an infant may safely continue to breast-feed from a mother who has undergone dental treatment after local anesthesia with lidocaine without adrenaline. Because there have been reports of several idiosyncratic reactions resulting from additives (e.g., methylparaben or sulfite) often used with local anesthetics (17,18), it may be advisable to use local anesthetics without adrenaline, even if adrenaline is destroyed during its passage through the gastrointestinal tract and its appearance in breast milk is unlikely (19).…”

Section: Discussionmentioning

confidence: 99%

Could Local Anesthesia While Breast‐Feeding Be Harmful to Infants?

Giuliani,

Grossi,

Pileri

et al. 2001

J. pediatr. gastroenterol. nutr.

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BackgroundFew studies have been carried out on the levels and possible toxicity of local anesthetics in breast milk after parenteral administration. The purpose of this study is to determine the amount of lidocaine and its metabolite monoethylglycinexylidide (MEGX) in breast milk after local anesthesia during dental procedures.MethodsThe study population consisted of seven nursing mothers (age, 23–39 years) who received 3.6 to 7.2 mL 2% lidocaine without adrenaline. Blood and milk concentrations of lidocaine and its metabolite MEGX were assayed using high‐performance liquid chromatography. The milk‐to‐plasma ratio and the possible daily doses in infants for both lidocaine and MEGX were calculated.ResultsThe lidocaine concentration in maternal plasma 2 hours after injection was 347.6 ± 221.8 μg/L, the lidocaine concentration in maternal milk ranged from 120.5 ± 54.1 μg/L (3 hours after injection) to 58.3 ± 22.8 μg/L (6 hours after injection), the MEGX concentration in maternal plasma 2 hours after injection was 58.9 ± 30.3 μg/L, and the MEGX concentration in maternal milk ranged from 97.5 ± 39.6 μg/L (3 hours after injection) to 52.7 ± 23.8 μg/L (6 hours after injection). According to these data and considering an intake of 90 mL breast milk every 3 hours, the daily infant dosages of lidocaine and MEGX were 73.41± 38.94 μg/L/day and 66.1 ± 28.5 μg/L/day respectively.ConclusionsThis study suggests that even if a nursing mother undergoes dental treatment with local anesthesia using lidocaine without adrenaline, she can safely continue breast‐feeding.

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Anaphylactic and anaphylactoid reactions due to anesthetic agents

Cited by 51 publications

References 57 publications

Analysis of Allergy and Hypersensitivity Reactions to COVID-19 Vaccines According to the EudraVigilance Database

Analysis of Allergy and Hypersensitivity Reactions to COVID-19 Vaccines According to the EudraVigilance Database

Analysis of allergy and hypersensitivity reactions to COVID-19 vaccines according to the EudraVigilance database

Could Local Anesthesia While Breast‐Feeding Be Harmful to Infants?

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