Incidence and clinical importance of perioperative histamine release: randomised study of volume loading and antihistamines after induction of anaesthesia

Lorenz, W.; Sitter, H.; Weber, D.; Rothmund, M.; Stinner, B.; Duda, D.; Dick, W.; Menke, H.; Junginger, T; Doenicke, Α.; Ohmann, Ch.; Black, Andy; Healy, M. J. R.

doi:10.1016/s0140-6736(94)90063-9

Cited by 143 publications

(95 citation statements)

References 12 publications

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“…We conclude that antihistamine prophylaxis has two benefits: significant reduction of the incidence of anaphylaxis during anaesthesia [1] and the incidence of PONV in the postoperative period [3,4,6,7].…”

Section: Resultsmentioning

confidence: 92%

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confidence: 99%

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Incidence of postoperative nausea and vomiting (PONV) after general pre-anaesthetic prophylaxis with antihistamines

Duda

Krummenauer

et al. 2004

Inflammation Research

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IntroductionAs a consequence of the Mainz-Marburg trial [1], in 1999 our clinic introduced a general pre-anaesthetic prophylaxis with histamine H 1 + H 2 -receptor antagonists in order to prevent perioperative anaphylactoid reactions. Thereafter the incidence of postoperative nausea and vomiting (PONV) also seemed to be reduced compared to reported values of 30 % [2, 3]. The aetiology of PONV is complex and multi-factorial, with at least four different types of receptors involved in vomiting. Currently the drugs used for prophylaxis and/or treatment of PONV include dopaminergic, histaminic, muscarinic and serotonergic (5-HT 3 ) receptor antagonists [3 -5]. The aim of this observational trial was to quantify the efficacy of p. o. or i. v. prophylaxis with histamine H 1 + H 2 -receptor antagonists on the incidence of PONV in clinical routine. Materials and methodsBetween April and September 2002, 500 patients (206 (41.2 %) male, 294 (58.8 %) female, 18 -101 years, ASA I-IV, without major thoracic/abdominal surgery) were consecutively questioned with regard to early (£ 6 h) and late (6 -24 h) postoperative nausea (= PON I and II) Inflamm. res. 53, Supplement 1 (2004) S91-S92 and vomiting (= POV I and II). For pre-anaesthetic sedation and anxiolysis, patients received oxazepam, lorazepam or clorazepate dipotassium p. o. on the day of operation. All patients had a prophylaxis with H 1 + H 2 -receptor antagonists (dimetindene plus cimetidine) either p. o. (4 mg + 200 mg, n = 145, 29 %) at least 1 h before anaesthesia or i. v. (5 mg + 0.1 mg/kg BW, n = 355, 71 %) immediately before anaesthesia. Additionally 20 ml sodium citrate were given p. o. 10 min before balanced anaesthesia (BA, n = 386, 77.2 %) with fentanyl, thiopentone, with and without muscle relaxant and desflurane in O 2 /air or regional anaesthesia (RA, n = 114, 22.8 %, all but 4 RA were spinal cord associated). About 30 min before the end of operation, all patients received analgesia with 2.5 g novaminsulfon.The study fulfilled the ethical requirements in Germany. Data were analysed using logistic regression analysis and Chi 2 -test with p < 0.05 indicating significance. Results and discussionOur results are in agreement with previous studies [6,7]. The incidence of vomiting after BA was comparable to other publications e. g. Doenicke et al. [6]. However, only early nausea was significantly less frequent (p = 0.03) after RA ( Table 1). As nearly all our RAs were spinal cord associated, it could be speculated that a decrease in blood pressure folTable 1. Incidence of PONV after balanced (BA) and regional anaesthesia (RA). BA RA Chi 2 -test Time n = 386 (77.2 %) n = 114 (22.8 %) BA vs. RA, p-value Vomiting Early 15 (3.9 %) 4 (3.9 %) n. s. Late 20 (5.2 %) 7 (6.1 %) n. s. Early and late 30 (7.8 %) 8 (7.0 %) n. s. Nausea Early 15 (3.9 %) 0 (0 %) 0.03 Late 22 (5.7 %) 4 (3.5 %) n. s. Early and late 35 (9.1 %) 4 (3.5 %) 0.03 Early = up to 6 h post-operatively. Late = 6 -24 h post-operatively. n. s. = not significant.

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Section: Resultsmentioning

confidence: 92%

“…

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mentioning

confidence: 99%

Incidence of postoperative nausea and vomiting (PONV) after general pre-anaesthetic prophylaxis with antihistamines

Duda

Krummenauer

et al. 2004

Inflammation Research

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“…This is especially true in the immediate perioperative period when many drugs are used that are able to elicit histamine release and histamine related cardio-respiratory disturbances during anaesthesia, in particular cardiovascular instability with hypotension below critical values (< 80 mmHg) and arrhythmias [2]. The detrimental consequences of those cardiovascular instabilities, such as silent myocardial infarction, during anaesthesia and their influence on postoperative outcome were demonstrated by Mangano and colleagues [3].…”

Section: Introductionmentioning

confidence: 99%

Early and late histamine release induced by albumin, hetastarch and polygeline: some unexpected findings

Çelik

Duda

Stinner³

et al. 2003

Inflammation Research

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“…Histamine release in the perioperative period can lead to detrimental intraoperative and postoperative outcome [1]. It can result in anaphylactoid reactions which compromise the function of vital organs [2].…”

Section: Introductionmentioning

confidence: 99%

“…It can result in anaphylactoid reactions which compromise the function of vital organs [2]. However, these effects of histamine release can be successfully blocked by preoperative administration of H 1 + H 2 -histamine receptor antagonists [1]. In trauma patients increased plasma histamine levels were observed [3].…”

Section: Introductionmentioning

confidence: 99%

Histamine content of human osseous tissue: detection and possible source of plasma histamine increase during orthopaedic surgery

Görike

Junge

Kunkel

et al. 2004

Inflammation Research

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Incidence and clinical importance of perioperative histamine release: randomised study of volume loading and antihistamines after induction of anaesthesia

Cited by 143 publications

References 12 publications

Incidence of postoperative nausea and vomiting (PONV) after general pre-anaesthetic prophylaxis with antihistamines

Incidence of postoperative nausea and vomiting (PONV) after general pre-anaesthetic prophylaxis with antihistamines

Early and late histamine release induced by albumin, hetastarch and polygeline: some unexpected findings

Histamine content of human osseous tissue: detection and possible source of plasma histamine increase during orthopaedic surgery

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