Anaphylactic reactions during paediatric anaesthesia; results of the survey of the French Society of Paediatric Anaesthetists (ADARPEF) 1991–1992

Murat, I.

doi:10.1111/j.1460-9592.1993.tb00101.x

Cited by 67 publications

(32 citation statements)

References 21 publications

(19 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In 1984, Turjanmaa et al (71) described the first cases of NRL-associated intra-operative anaphylaxis. By 1996, NRL was reported to account for approximately 20% of anaesthetic anaphylaxis, and, by 2000, had been reported to account for as much as 17% of these reactions in the general population (14) and 27-76% in a paediatric population (2,16). However, longitudinal epidemiological data suggest anaesthetic anaphylaxis from NRL might be Ôover the topÕ (14), in part because of an increased awareness and primary preventive measures.…”

Section: Natural Rubber Latexmentioning

confidence: 93%

“…In contrast, anaphylaxis from natural rubber latex (NRL) and antiseptics exhibit a more delayed onset and generally occurs during maintenance anaesthesia or recovery, as a result of later application or absorption through skin, mucosal surfaces and/or soft tissues, or removal of a tourniquet (2,17,18). In patients allergic to latex, bronchospasm may also be observed early following arrival of a sensitized patient in the operating theatre.…”

Section: Time Elapsed Between Administration and Onset-of-symptomsmentioning

confidence: 99%

“…In most cases, perioperative anaphylaxis is characterized by severe respiratory and cardiovascular manifestations such as arterial hypotension and cardiovascular collapse (2,3,5,(14)(15)(16). The differential diagnosis of anaesthesiarelated anaphylaxis is shown in Table 1.…”

Section: Extent Of Signsmentioning

confidence: 99%

“…Atopic individuals are particularly at risk for anaphylaxis from NRL during anaesthesia (2,3,(14)(15)(16). Patients with …”

Section: Underlying Conditionsmentioning

confidence: 99%

“…The estimated overall frequency has been reported to vary between 1 in 3500 and 1 in 13 000 procedures in French series (2,3) and between 1 in 10 000 and 1 in 20 000 in an Australian study (4). The clinical manifestation of these reactions is not infrequently an almost immediate generalized response with bronchospasm and hypotension.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Anaphylaxis during anaesthesia: diagnostic approach

Ebo¹,

Fisher²,

Hagendorens³

et al. 2007

Allergy

193

197

View full text Add to dashboard Cite

Anaesthesiologists administer several drugs while providing general anaesthesia. Many of these drugs can elicit adverse drug reactions that fall apart into two major types. First, reactions that are usually dose-dependent and related to the pharmacological properties of the drug and/or its metabolites. Second, reactions that are unrelated to the drug's pharmacological characteristics and that are less dose-dependent. These reactions comprise drug intolerance, idiosyncratic reactions and drug-induced immune-mediated allergic and nonimmune-mediated so-called pseudo-allergic or anaphylactoid reactions. The terms anaphylactic and anaphylactoid, however, have been used inconsistently in the literature. Therefore, the nomenclature task force set up by the European Academy of Allergy and Immunology (EAACI) has proposed that anaphylactic-type reactions should be reclassified into allergic anaphylaxis and nonallergic anaphylaxis. Allergic anaphylaxis being further subdivided in IgE-mediated and non-IgE-mediated reactions (1).The exact prevalence of anaphylaxis during anaesthesia is difficult to ascertain. The estimated overall frequency has been reported to vary between 1 in 3500 and 1 in 13 000 procedures in French series (2, 3) and between 1 in 10 000 and 1 in 20 000 in an Australian study (4). The clinical manifestation of these reactions is not infrequently an almost immediate generalized response with bronchospasm and hypotension. The degree of severity varies and does not allow differentiation between an IgE-mediated or non-IgE mediated reaction resulting from nonspecific mediator release (5). The mortality from these reactions is in the range from 3 to 6%, and an additional 2% of patients experience significant residual brain damage (4).Diagnosis of anaphylaxis during anaesthesia is not always straightforward. It can be hampered as a broad spectrum of different drugs can elicit heterogeneous allergic and nonallergic reactions with distinct and sometimes unclear pathological mechanisms. Problems are certainly compounded as multiple drugs need to be administered during general anaesthesia. In addition, nonanaesthesia related drugs or procedures (e.g. disinfection) are sometimes administered/performed in the perioperative period and can also be the cause of an allergic reaction.In addition, none of the available diagnostic tests demonstrates absolute accuracy. False-positive test Correct management of anaphylaxis during anaesthesia requires a multidisciplinary approach with prompt recognition and treatment of the acute event by the attending anaesthesiologist, and subsequent determination of the responsible agent(s) with strict avoidance of subsequent administration of all incriminated and/or cross-reacting compounds.However, correct identification of the causative compound(s) and safe alternatives is not always straightforward and, too often, not done.This review is not intended to discuss acute management of anaesthesia-related anaphylaxis but summarizes the major causes of anaphylaxis during anaesthesia and the di...

show abstract

Section: Natural Rubber Latexmentioning

confidence: 93%

Section: Time Elapsed Between Administration and Onset-of-symptomsmentioning

confidence: 99%