Anaphylaxis during anesthesia: results of a 12‐year survey at a French pediatric center

Karila, C.; Brunet-Langot, D; Labbez, Franciane; Jacqmarcq, O.; Ponvert, C.; Paupe, J; Scheinmann, P.; Blic, J. de

doi:10.1111/j.1398-9995.2005.00787.x

Cited by 92 publications

(94 citation statements)

References 36 publications

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“…In most cases, perioperative anaphylaxis is characterized by severe respiratory and cardiovascular manifestations such as arterial hypotension and cardiovascular collapse (2,3,5,(14)(15)(16). The differential diagnosis of anaesthesiarelated anaphylaxis is shown in Table 1.…”

Section: Extent Of Signsmentioning

confidence: 99%

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Anaphylaxis during anaesthesia: diagnostic approach

Ebo¹,

Fisher²,

Hagendorens³

et al. 2007

Allergy

195

197

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Anaesthesiologists administer several drugs while providing general anaesthesia. Many of these drugs can elicit adverse drug reactions that fall apart into two major types. First, reactions that are usually dose-dependent and related to the pharmacological properties of the drug and/or its metabolites. Second, reactions that are unrelated to the drug's pharmacological characteristics and that are less dose-dependent. These reactions comprise drug intolerance, idiosyncratic reactions and drug-induced immune-mediated allergic and nonimmune-mediated so-called pseudo-allergic or anaphylactoid reactions. The terms anaphylactic and anaphylactoid, however, have been used inconsistently in the literature. Therefore, the nomenclature task force set up by the European Academy of Allergy and Immunology (EAACI) has proposed that anaphylactic-type reactions should be reclassified into allergic anaphylaxis and nonallergic anaphylaxis. Allergic anaphylaxis being further subdivided in IgE-mediated and non-IgE-mediated reactions (1).The exact prevalence of anaphylaxis during anaesthesia is difficult to ascertain. The estimated overall frequency has been reported to vary between 1 in 3500 and 1 in 13 000 procedures in French series (2, 3) and between 1 in 10 000 and 1 in 20 000 in an Australian study (4). The clinical manifestation of these reactions is not infrequently an almost immediate generalized response with bronchospasm and hypotension. The degree of severity varies and does not allow differentiation between an IgE-mediated or non-IgE mediated reaction resulting from nonspecific mediator release (5). The mortality from these reactions is in the range from 3 to 6%, and an additional 2% of patients experience significant residual brain damage (4).Diagnosis of anaphylaxis during anaesthesia is not always straightforward. It can be hampered as a broad spectrum of different drugs can elicit heterogeneous allergic and nonallergic reactions with distinct and sometimes unclear pathological mechanisms. Problems are certainly compounded as multiple drugs need to be administered during general anaesthesia. In addition, nonanaesthesia related drugs or procedures (e.g. disinfection) are sometimes administered/performed in the perioperative period and can also be the cause of an allergic reaction.In addition, none of the available diagnostic tests demonstrates absolute accuracy. False-positive test Correct management of anaphylaxis during anaesthesia requires a multidisciplinary approach with prompt recognition and treatment of the acute event by the attending anaesthesiologist, and subsequent determination of the responsible agent(s) with strict avoidance of subsequent administration of all incriminated and/or cross-reacting compounds.However, correct identification of the causative compound(s) and safe alternatives is not always straightforward and, too often, not done.This review is not intended to discuss acute management of anaesthesia-related anaphylaxis but summarizes the major causes of anaphylaxis during anaesthesia and the di...

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Section: Extent Of Signsmentioning

confidence: 99%

“…Atopic individuals are particularly at risk for anaphylaxis from NRL during anaesthesia (2,3,(14)(15)(16). Patients with …”

Section: Underlying Conditionsmentioning

confidence: 99%

Anaphylaxis during anaesthesia: diagnostic approach

Ebo¹,

Fisher²,

Hagendorens³

et al. 2007

Allergy

195

197

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“…Reactions to etomidate and ketamine are also rare; in fact etomidate is considered one of the safest drugs in anaesthesia concerning allergic reactions [7,81].…”

Section: A) Drugsmentioning

confidence: 99%

Practical Guidelines for Perioperative Hypersensitivity Reactions

Laguna¹,

Archilla²,

Doña³

et al. 2018

J Investig Allergol Clin Immunol

105

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Perioperative hypersensitivity reactions constitute a first-line problem for anesthesiologists and allergists, so it is advisable that hospitals have a consensus protocol for the diagnosis and management of these reactions. However, this kind of protocols is not present in many hospitals, leading to problems in treatment, the communication of incidents and subsequent etiological diagnosis. In this document we present a systematic review of the available scientific evidence and provide general guidelines for the management of acute episodes and Resumen:Las reacciones de hipersensibilidad perioperatorias constituyen un problema de primera línea para los anestesiólogos y alergólogos, por lo que es recomendable que los hospitales tengan un protocolo de consenso para el diagnóstico y el tratamiento de estas reacciones. Sin embargo, este tipo de protocolos no está presente en muchos hospitales, lo que conlleva problemas en el tratamiento, la comunicación de incidentes y el posterior diagnóstico etiológico. Este documento ha sido creado por miembros del Comité de Alergia a Medicamentos de la Sociedad Española de Alergia e Inmunología Clínica (SEAIC) en colaboración con miembros de la Sociedad Española de Anestesia (SEDAR). Se ha realizado una revisión sistemática de la evidencia científica disponible y se proporcionan pautas generales para el manejo de episodios agudos y para la derivación de pacientes con reacciones de hipersensibilidad perioperatoria a los Servicios de Alergología. Se propone un algoritmo práctico para el diagnóstico etiológico y se brindan recomendaciones para el manejo de pacientes con reacciones alérgicas perioperatorias.

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“…Em todas as variáveis, a área sob a curva foi maior do que 0,690. [46][47][48]74 . Além disto, o paciente pode estar sensibilizado ao látex, mas ainda não ter tido exposição ao produto para desencadear uma reação alérgica, tornando a história clínica, muitas vezes, imprecisa.…”

Section: Imunológicosunclassified

“…Entretanto, Bernardini et al 47,82 . O histórico de alergias, principalmente ao látex, foi um importante dado, uma vez que no presente estudo foi um fator de risco independente para a sensibilização ao látex.…”

Section: Imunológicosunclassified

Sensibilização ao látex em pacientes com mielomeningocele na urologia do HC-FMUSP: prevalência e fatores associados

Soares¹

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Anaphylaxis during anesthesia: results of a 12‐year survey at a French pediatric center

Abstract: As in adults, NMBA, then latex were responsible for most anaphylactic reactions during anesthesia. Our results confirm that skin tests with anesthetic agents are feasible and safe in children and improve the safety of subsequent anesthetic procedures.

Cited by 92 publications

References 36 publications

Anaphylaxis during anaesthesia: diagnostic approach

Anaphylaxis during anaesthesia: diagnostic approach

Practical Guidelines for Perioperative Hypersensitivity Reactions

Sensibilização ao látex em pacientes com mielomeningocele na urologia do HC-FMUSP: prevalência e fatores associados

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