Anaphylactic and Anaphylactoid Reactions Occurring during Anesthesia in France in 1999–2000

Abstract

These results further corroborate the need for systematic screening in the case of anaphylactoid reaction during anesthesia and for the constitution of allergoanesthesia centers to provide expert advice to anesthesiologists and allergists.

Laryngeal injuries and intubating conditions with or without muscular relaxation: an equivalence study

“…First, since the primary outcome of our study was the incidence of SLI, use of a depolarizing agent was avoided, because the role of succinylcholine in the etiology of postoperative sore throat and hoarseness remains unclear. 2,3,23 Second, cisatracurium is reported to produce less histamine release and fewer allergic reactions compared to other nondepolarizing NMBDs, such as rocuronium, 7,24 even though reports of anaphylactic reactions after cisatracurium administration were published since its introduction into clinical anesthesia. 7 The mean onset of action of cisatracurium was > six minutes, inducing a mean delay of three minutes of the first attempt to intubate the trachea compared to the patients in group Placebo.…”

“…2,3,23 Second, cisatracurium is reported to produce less histamine release and fewer allergic reactions compared to other nondepolarizing NMBDs, such as rocuronium, 7,24 even though reports of anaphylactic reactions after cisatracurium administration were published since its introduction into clinical anesthesia. 7 The mean onset of action of cisatracurium was > six minutes, inducing a mean delay of three minutes of the first attempt to intubate the trachea compared to the patients in group Placebo. In order to have a reliable diagnosis of residual curarization and to guide reversal, we monitored the adductor pollicis muscle as a surrogate marker of the degree of cisatracurium block at the laryngeal muscle.…”

“…5,6 However, patient factors may contraindicate the use of NMBDs, and administration of NMBDs may be associated with several potentially serious complications, such as anaphylactic reactions, residual curarization (even after a single intubating dose of NMBD), and awareness during general anesthesia. [7][8][9] Moreover, high rates of good to excellent intubating conditions have been reported without the use of NMBDs, provided that the anesthetic induction protocol is optimized with an adequate dose of an opioid analgesic co-administered with either propofol or thiopental. [10][11][12][13][14][15][16] Due to its rapid onset, remifentanil 2 µg·kg -1 , combined with propofol 2 mg·kg -1 , provides acceptable intubating conditions in 75 to 85% of patients.…”

Operating conditions for ocular surgery under general anaesthesia: an eccentric problem

“…2 Therefore, we believe that NDMRs should be considered only as a last resort after failure of local anaesthetics, traction sutures, and the tincture of time to stabilize the globe.…”

“…Eye forced duction test and impeding access to the extraocular muscles. 2,3 In a recent survey carried out in the Southwest of England, neuromuscular blocking agents were used in only 45% of children and 34% of adults undergoing strabismus surgery. 4 The authors point out that conditions for forced duction test and ocular access may be less than ideal in a large proportion of patients undergoing strabismus surgery.…”