Cross-sectional study of perioperative drug and allergen exposure in UK practice in 2016: the 6th National Audit Project (NAP6) Allergen Survey

Abstract

This survey provides insights into allergen exposures in perioperative care, which is important as denominator data for the NAP6 registry.

Comparison of incidence of anaphylaxis between sugammadex and neostigmine: a retrospective multicentre observational study

“…In addition to the share of each NMBA, the overall high rate of the use of all NMBAs in the current study is also noteworthy: 94.3% of patients who received general anaesthesia were administered NMBAs, whilst the NMBA usage rate reported in the NAP6 was 47%. 29 Of patients undergoing general anaesthesia who received NMBAs, antagonists were used in 70.9% of cases in our study, compared with 62% in NAP6. Therefore, in general anaesthesia cases, antagonists to NMBAs are used 2.3 times more often in Japan than in the UK.…”

“…Conversely, a recent UK study showed that neostigmine was used in 92% of all reversed cases. 29 One of the reasons for this disparity might be the differences in the NMBAs used in the UK and in Japan. The share of NMBAs in the UK shown by the National Audit Project 6 (NAP6) was atracurium (45%), rocuronium (38%), and succinylcholine (10%), 29 whilst only rocuronium, vecuronium, and succinylcholine are commercially available in Japan.…”

“…29 One of the reasons for this disparity might be the differences in the NMBAs used in the UK and in Japan. The share of NMBAs in the UK shown by the National Audit Project 6 (NAP6) was atracurium (45%), rocuronium (38%), and succinylcholine (10%), 29 whilst only rocuronium, vecuronium, and succinylcholine are commercially available in Japan. In our study, the share of rocuronium was 95.7%, and those of vecuronium and succinylcholine were 0.5% and 3.7%, respectively.…”

Specialist perioperative allergy clinic services in the UK 2018: Results from the Royal College of Anaesthetists Sixth National Audit Project (NAP6) investigation of perioperative anaphylaxis

“…Failure to offer appropriate IDT and challenge testing resulted in inappropriate avoidance in some cases. Inappropriate avoidance advice because of a low probability of penicillin allergy (not confirmed on clinic evaluation) was a problem and resulted in reactions to teicoplanin . Use of teicoplanin as a penicillin substitute is increasing; proper pre‐procedure evaluation for true penicillin allergy may reduce this.…”

“…Inappropriate avoidance advice because of a low probability of penicillin allergy (not confirmed on clinic evaluation) was a problem and resulted in reactions to teicoplanin. 33 Use of teicoplanin as a penicillin substitute is increasing; proper pre-procedure evaluation for true penicillin allergy may reduce this. If penicillin avoidance advice is given, specific advice should also be given on safe alternatives.…”