ADVERSE REACTIONS TO INTRAVENOUS ANAESTHETICS: A Survey of 100 Reports

Abstract

One hundred consecutive reports of reactions to intravenous anaesthetics Althesin, thiopentone and Epontol are reviewed and analysed. Ten reactions are attributed to causes other than the anaesthetic drug, and four are believed to have been caused by the muscle relaxant employed. The remaining 86 reactions were grouped according to their clinical presentation: histaminoid reactions ( 19), histaminoid with bronchospasm (33), bronchospasm (12), cardiovascular collapse (uu), delayed histaminoid reactions (6), and clonic contractions (5). None of the first four reaction types was associated with only one anaesthetic. A knowledge of the sales of Althesin has allowed the incidence of reactions to be estimated as between one in 11,000 and one in 19,000.

Two cases of untoward sequelae associated with thiopentone

“…These have been reviewed by Clarke et a1. 8 Dundee' found about thirty reported cases involving thiopentone, nineteen of which had been reported in the last 4 years. This may either represent an increasing incidence of the event or only an increase in the reporting of the events.…”

Histamine release in dogs by Cremophor El® and its derivatives: Oxethylated oleic acid is the most effective constituent

“…In 1975 CLARKE et al [9] reported 100 adverse reactions to althesin in England, the incidence of these reactions to propanidid and althesin is claimed to be between 1 : 1000 and 1:7000 applications [5,10]. If on considers the great number of anaesthesia per year in every country of Europe the eminent clinical problem arising from such epidemiological studies is apparent.…”

Histamine in Anaesthesia and Surgery: Causality Analysis

“…The second network of evidence that histamine was involved in adverse reactions to drugs used in anaesthesia and surgery was provided by British and Australian authors in the mid-1970s, who collected and clinically analysed hundreds of cases of more or less severe incidents to a variety of compounds (DUNDEE and WYANT 1974;SUTTON et al 1974;CLARKE et al 1975;FISHER 1975). These groups concentrated their interest on clinical features and predisposing factors for anaphylactoid reactions to drugs used in anaesthesia and surgery.…”