Anaphylaxis to Muscle Relaxants: An Audit of Ten Years of Allergy Testing at the Royal Adelaide Hospital

Brereton, Avril Vaux; Wj, Russell

doi:10.1177/0310057x1204000515

Cited by 18 publications

(24 citation statements)

References 19 publications

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“…There was similarity between the incidence of anaphylaxis to rocuronium and succinylcholine (approximately 1:2,500 and 1:2,000, respectively); in contrast, the rate of anaphylaxis to atracurium was substantially lower (1:22,000). 2,[4][5][6][7][8]15 The characterization of our patient series, with 56% of anaphylaxis cases being found to be allergic and associated with higher tryptase and greater severity than nonallergic cases, is similar to that in other published studies. 1,6,8 No cases of anaphylaxis were observed for vecuronium (0 of 9,585 new exposures).…”

Section: Discussionsupporting

confidence: 68%

“…This difference is unlikely to be an artifact due to the large numbers in the denominators, and this observation is supported by several large European studies. 1,2,4,8 The study provides direct calculation of comparative rates of anaphylaxis based on actual measurement of denominator data. The proportion of anaphylaxis events during anesthesia resulting from sensitization to NMBDs (46%) is similar to that reported in France, Norway, Spain, and Australia.…”

Section: Discussionmentioning

confidence: 99%

“…2,[4][5][6][7][8] There is controversy whether the incidence of anaphylaxis is higher with rocuronium than with other NMBDs. 1-3 Neuromuscular-blocking drugs (NMBDs) are common causative agents during anesthesia.…”

mentioning

confidence: 99%

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Anaphylaxis Is More Common with Rocuronium and Succinylcholine than with Atracurium

et al. 2015

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Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

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Anaphylaxis Is More Common with Rocuronium and Succinylcholine than with Atracurium

et al. 2015

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“…[2] In a recent 10 years audit at the Royal Adelaide University Hospital, Australia, the majority of the patients with anaphylaxis to muscle relaxants during anesthesia were to rocuronium and suxamethonium. [13] This may explain our finding that only 17% of the respondents noted skin rash or bronchospasm related to the administration of rocuronium.…”

Section: Discussionmentioning

confidence: 92%

A survey of the current use of neuromuscular blocking drugs among the Middle Eastern anesthesiologists

Eldawlatly

El-Tahan

2013

Saudi J Anaesth

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Background:This survey aimed to assess the extent of practice of the Middle Eastern anesthesiologists in the use of neuromuscular blocking agents (NMB) in 2012.Methods:We distributed an electronic survey among 577 members of the Triple-M Middle Eastern Yahoo anesthesia group, enquiring about their practice in the use of neuromuscular blocking agents. Questions concerned the routine first choice use of NMB, choice for tracheal intubation, the use of neuromuscular monitoring (NMT), type of NMB used in difficult airway, frequency of using suxamethonium, cisatracurium, rocuronium and sugammadex, observed side effects of rocuronium, residual curarization, and the reversal of residual curarization of rocuronium.Results:A total of 71 responses from 22 Middle Eastern institutions were collected. Most of the Middle Eastern anesthesiologists were using cisatracurium and rocuronium frequently for tracheal intubation (39% and 35%, respectively). From the respondents, 2/3 were using suxamethonium for tracheal intubation in difficult airway, 1/3 were using rocuronium routinely and 17% have observed hypersensitivity reactions to rocuronium, 54% reported residual curarization from rocuronium, 78% were routinely using neostigmine to reverse the rocuronium, 21% used sugammadex occasionally, and 35% were using NMT routinely during the use of NMB.Conclusions:We believe that more could be done to increase the awareness of the Middle Eastern anesthesiologists about the high incidence of PROC (>20%) and the need for routine monitoring of neuromuscular function. This could be accomplished with by developing formal training programs and providing official guidelines.

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“…Rocuronium and succinylcholine were the most common agents related with anaphylaxis [9]. Cisatracurium as the representative drug of benzylisoqunolinium also cannot be free from the allergic reaction.…”

mentioning

confidence: 99%

In the hour of Sugammadex

Chon

2013

Korean J Anesthesiol

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Sugammadex is a modified gamma-cyclodextrin which is showing favorable outcomes regarding reversal of neuromuscular blockade, especially by rocuronium. It is designed to encapsulate rocuronium and being considered a new class of drugs as selective relaxant binding agents. It has given countless benefits to the patients at risk of incomplete or delayed recovery after neuromuscular block and has renown for another milestone in anesthesia practice. Recurrence of neuromuscular block has not been reported to be associated with the provided doses of sugammadex that are adequate for selected for reversal. Acceptable profiles are brought to light telling safety of sugammadex. However, some questions related to the twitch characteristics those resembled succinylcholine when reversal, the application for rocuronium anaphylaxis, and the hypersensitivity or anaphylaxis to sugammadex remain and are need of further investigation. It is imperative that potential problems that we need attention may include the patient's history of pulmonary disease and allergic disease for using sugammadex.

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Anaphylaxis to Muscle Relaxants: An Audit of Ten Years of Allergy Testing at the Royal Adelaide Hospital

Cited by 18 publications

References 19 publications

Anaphylaxis Is More Common with Rocuronium and Succinylcholine than with Atracurium

Anaphylaxis Is More Common with Rocuronium and Succinylcholine than with Atracurium

A survey of the current use of neuromuscular blocking drugs among the Middle Eastern anesthesiologists

In the hour of Sugammadex

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