Drugs and other agents involved in anaphylactic shock occurring during anaesthesia. A French multicenter epidemiological inquiry

Anaesthesia-associated hypersensitivity reactions: seven years' data from a British bi-specialty clinic

“…In the largest series of anaesthesia-associated IgE-mediated hypersensitivity reactions published (from France), the commonest culprit agents were neuromuscular blocking drugs (47.4%), latex (20%), antibiotics (18.1%) and dyes (4.4%) [15]. In France, there is a well-established network of clinics (GERAP) dedicated to the investigation of peri-operative anaphylaxis using a standardised protocol [16]. Both our study and the above French study (Dong et al) showed that although neuromuscular blocking drugs were still the major cause of IgE-mediated reactions, they accounted for an lower proportion of cases from 1993 to 2012 [15][16][17][18][19].…”

“…In France, there is a well-established network of clinics (GERAP) dedicated to the investigation of peri-operative anaphylaxis using a standardised protocol [16]. Both our study and the above French study (Dong et al) showed that although neuromuscular blocking drugs were still the major cause of IgE-mediated reactions, they accounted for an lower proportion of cases from 1993 to 2012 [15][16][17][18][19]. This trend is similar to that reported by investigators in Australia, who found that neuromuscular blocking drugs accounted for 38% of cases [20].…”

Anaphylaxis caused by neostigmine

“…suxamethonium, vecuronium or atracurium [5,6]. In France, muscle relaxants were responsible for 70% of 813 cases of anaphylaxis during anaesthesia, suxamethonium accounting for the majority [5]. Neostigmine is an anticholinesterase drug, frequently used for reversal of nondepolarising neuromuscular blockade.…”

“…The term anaphylactoid reaction is used for a reaction clinically similar to anaphylaxis, but where the mechanism is different and IgE antibody is not involved. In France, the incidence of anaphylactic or anaphylactoid reactions during anaesthesia is 1 in 3500 and for anaphylaxis (reactions shown to be IgE-mediated) 1 in 6000 [4,5]. Data from 1990 to 1991 show that most of the anaphylaxis associated with anaesthesia is due to neuromuscular blocking drugs [5], but recent studies show that latex rubber allergy is now accounting for an increasing proportion.…”

“…In France, the incidence of anaphylactic or anaphylactoid reactions during anaesthesia is 1 in 3500 and for anaphylaxis (reactions shown to be IgE-mediated) 1 in 6000 [4,5]. Data from 1990 to 1991 show that most of the anaphylaxis associated with anaesthesia is due to neuromuscular blocking drugs [5], but recent studies show that latex rubber allergy is now accounting for an increasing proportion. This is the ®rst report of a case of anaphylaxis due to neostigmine, providing con®rmatory evidence of the aetiology.…”