No cases of perioperative allergy to local anaesthetics in the Danish Anaesthesia Allergy Centre

Kvisselgaard, Ask D.; Krøigaard, Mogens; Mosbech, H.; Garvey, Lene Heise

doi:10.1111/aas.12833

Cited by 41 publications

(21 citation statements)

References 39 publications

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“…Despite their widespread use, IgE‐mediated hypersensitivity reactions to local anaesthetics are reported extremely rarely . A recent study confirms this in the perioperative setting …”

Section: Epidemiology and Important Causesmentioning

confidence: 92%

“…In the highly specialized Danish Anaesthesia Allergy Centre, DPTs have been done routinely since 2004 with most drugs, when skin tests are negative, inconclusive or suspected to be false positive. 21,33,41,45,47,98 In smaller less specialized centres, it may be possible for allergists to collaborate with local anaesthetists about individual patients that might benefit from DPT with drugs used in the perioperative setting, after a careful risk-benefit evaluation.…”

Section: Drug Provocation Testing (Dpt)mentioning

confidence: 99%

“…Recent guidelines on POH from Spain suggest that DPT can be undertaken for anaesthetic drugs in highly specialized centres with full monitoring and resuscitation facilities, for example in a recovery unit/operating room . In the highly specialized Danish Anaesthesia Allergy Centre, DPTs have been done routinely since 2004 with most drugs, when skin tests are negative, inconclusive or suspected to be false positive …”

Section: In Vitro Testingmentioning

confidence: 99%

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An EAACI position paper on the investigation of perioperative immediate hypersensitivity reactions

Garvey

Ebo

Mertès

et al. 2019

Allergy

167

202

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Perioperative immediate hypersensitivity reactions are rare. Subsequent allergy investigation is complicated by multiple simultaneous drug exposures, the use of drugs with potent effects and the many differential diagnoses to hypersensitivity in the perioperative setting. The approach to the investigation of these complex reactions is not standardized, and it is becoming increasingly apparent that collaboration between experts in the field of allergy/immunology/dermatology and anaesthesiology is needed to provide the best possible care for these patients. The EAACI task force behind this position paper has therefore combined the expertise of allergists, immunologists and anaesthesiologists. The aims of this position paper were to provide recommendations for the investigation of immediate-type perioperative hypersensitivity reactions and to provide practical information that can assist clinicians in planning and carrying out investigations. | 1873GARVEY Et Al.

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“…Despite their widespread use, IgE‐mediated hypersensitivity reactions to local anaesthetics are reported extremely rarely . A recent study confirms this in the perioperative setting …”

Section: Epidemiology and Important Causesmentioning

confidence: 92%

Section: Drug Provocation Testing (Dpt)mentioning

confidence: 99%

Section: In Vitro Testingmentioning

confidence: 99%

See 1 more Smart Citation

An EAACI position paper on the investigation of perioperative immediate hypersensitivity reactions

Garvey

Ebo

Mertès

et al. 2019

Allergy

167

202

View full text Add to dashboard Cite

show abstract

“…This is especially important when the local anaesthetic is not the most suspected drug. 17,47 The survey showed that 10/13 ISPAR centres and 15/21 ANZAAG centres perform DPT with local anaesthetics.…”

Section: Local Anaestheticsmentioning

confidence: 99%

The use of drug provocation testing in the investigation of suspected immediate perioperative allergic reactions: current status

Garvey

Ebo

Krøigaard

et al. 2019

British Journal of Anaesthesia

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Suspected perioperative allergic reactions are often severe. To avoid potentially life-threatening re-exposure to the culprit drug, establishing a firm diagnosis and identifying the culprit is crucial. Drug provocation tests are considered the gold standard in drug allergy investigation but have not been recommended in the investigation of perioperative allergy, mainly because of the pharmacological effects of drugs such as induction agents and neuromuscular blocking agents. Some specialised centres have reported benefits of provocation testing in perioperative allergy investigation, but the literature on the subject is limited. Here we provide a status update on the use of drug provocation testing in perioperative allergy, including its use in specific drug groups. This review is based on a literature search and experiences of the authors comprising anaesthesiologists and allergists with experience in perioperative allergy investigation. In addition, 19 participating centres in the International Suspected Perioperative Allergic Reaction Group were surveyed on the use of provocation testing in perioperative allergy investigation. A response was received from 13 centres in eight European countries, New Zealand, and the USA. Also, 21 centres from the Australian and New Zealand Anaesthetic Allergy Group were surveyed. Two centres performed provocation routinely and seven centres performed no provocations at all. Nearly half of the centres reported performing provocations with induction agents and neuromuscular blocking agents. Drug provocation testing is being used in perioperative allergy investigation in specialised centres, but collaborations between relevant specialties and multicentre studies are necessary to determine indications and establish common testing protocols.

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“…1 A Danish national survey over a 10-year period found that none of 162 patients with suspected perioperative hypersensitivity exposed to LAs had been diagnosed with true allergy. 9 Allergic reactions to LAs during anesthesia and surgery, especially anaphylaxis, can be life-threatening. It is a challenge for doctors to provide appropriate pain management for patients with true allergy to LAs.…”

Section: Introductionmentioning

confidence: 99%

Risk of True Allergy to Local Anesthetics: 10-Year Experience from an Anesthesia Allergy Clinic in China

Zuo

Gong

Liu

et al. 2020

TCRM

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No cases of perioperative allergy to local anaesthetics in the Danish Anaesthesia Allergy Centre

Cited by 41 publications

References 39 publications

An EAACI position paper on the investigation of perioperative immediate hypersensitivity reactions

An EAACI position paper on the investigation of perioperative immediate hypersensitivity reactions

The use of drug provocation testing in the investigation of suspected immediate perioperative allergic reactions: current status

Risk of True Allergy to Local Anesthetics: 10-Year Experience from an Anesthesia Allergy Clinic in China

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