Management of a Parturient with Mast Cell Activation Syndrome: An Anesthesiologist’s Experience

Kumaraswami, Sangeeta; Farkas, Gary J.

doi:10.1155/2018/8920921

Cited by 2 publications

(3 citation statements)

References 16 publications

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“…Two articles justify not using of sugammadex due to its unavailability [ 12 , 13 ]. In another article, sugammadex is proposed as an acceptable option in pregnant women with mastocytosis, although in the reported case neuraxial anesthesia was used [ 14 ].…”

Section: Resultsmentioning

confidence: 99%

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Sugammadex in systemic mastocytosis

et al. 2021

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Perioperative management in patients suffering from systemic mastocytosis is challenging. Most recommendations regarding anesthetic management in these patients are based on clinical reports, and there are controversies about the use of rocuronium and sugammadex. We present a case report of a patient with systemic mastocytosis who was given sugammadex for rocuronium reversal. Tryptase levels were monitored during the first postoperative 24 h, without evidence of elevation. We also performed a systematic review to provide an overview of current evidence regarding the safety of using sugammadex in patients suffering from systemic mastocytosis. The search strategy included PubMed and Google Scholar. All studies published up to and including January 2021 concerning anesthetic management in systemic mastocytosis were included. Of the 122 articles located, 9 articles were included: 2 reviews and 7 case reports. Data from reviewed studies confirm that sugammadex can safely be administered in patients suffering from systemic mastocytosis.

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Section: Resultsmentioning

confidence: 99%

“…(2016) [ 13 ] Acceptable alternative (not used) Not available No Case report: electroconvulsive therapy Kumaraswami et al. (2018) [ 14 ] Acceptable (not used) Acceptable (not used) No Case report: vaginal delivery with neuraxial analgesia in mast cell activation syndrome …”

Section: Methods: Systematic Reviewmentioning

confidence: 99%

Sugammadex in systemic mastocytosis

et al. 2021

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“…We have included the following tables for further guidance. Tables 1 and 2 summarize components of the obstetric preanesthetic assessment that have specific considerations [5][6][7][8][9][10][11][12]. Table 3 summarizes benefits, risks, and alternatives of neuraxial and general anesthesia when providing counseling to patients [4,[13][14][15].…”

Section: High-risk Obstetric and Fetus-related Considerationsmentioning

confidence: 99%

Complex Pathology and Management in the Obstetric Patient: A Narrative Review for the Anesthesiologist

Metzger¹,

Teitelbaum²,

Weber³

et al. 2021

Cureus

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Pregnant patients may present with multiple complex comorbidities that can affect peripartum management and anesthetic care. The preanesthesia clinic is the ideal setting for early evaluation of high-risk pregnant patients. Comorbidities may include cardiovascular pathology such as valvular abnormalities, septal defects, aortopathies, arrythmias and cardiomyopathies. Additional comorbidities include pulmonary conditions such as obstructive sleep apnea as well as preexisting neuromuscular and skeletal disorders that may impact anesthetic management. Hematologic conditions involving both bleeding diathesis and thrombophilias may present unique challenges for the anesthesiologist. Patients may also present with endocrinopathies including diabetes and obesity. While not as common, high-risk patients may also have preexisting gastrointestinal conditions such as liver dysfunction, renal failure, and even post-transplant status. Ongoing and prior substance abuse, obstetric conditions such as placenta accreta spectrum disorders, and fetal conditions needing ex utero Intrapartum treatment also require advanced planning. Preanesthesia evaluations also help address important ethical and cultural considerations. Counseling patients regarding anesthetic considerations as well as addressing concerns will play a role in reducing racial and ethnic disparities. Anticipatory guidance by means of pre-anesthetic planning can facilitate multidisciplinary communication and planning. This can allow for an impactful and meaningful role in the care provided, allowing for safe maternal care and optimal outcomes.

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Management of a Parturient with Mast Cell Activation Syndrome: An Anesthesiologist’s Experience

Cited by 2 publications

References 16 publications

Sugammadex in systemic mastocytosis

Sugammadex in systemic mastocytosis

Complex Pathology and Management in the Obstetric Patient: A Narrative Review for the Anesthesiologist

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