Neuromuscular blocking agents induced anaphylaxis: Results and trends of a French pharmacovigilance survey from 2000 to 2012

Petitpain, Nadine; Argoullon, Ludovic; Masmoudi, Kamel; Fédrizzi, Sophie; Cottin, Judith; Latarche, Clotilde; Mertès, Paul-Michel; Gillet, Pierre

doi:10.1111/all.13456

Cited by 37 publications

(22 citation statements)

References 41 publications

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“…A nationwide analysis in France over the period 2000-2012 and published in 2018 that followed the occurrence of post-administration anaphylactic reactions of suxamethonium and rocuronium versus atracurium or cisatracurium found the involvement of suxamethonium in 64% of the adverse reactions (40).…”

Section: Discussionmentioning

confidence: 99%

“…Finally, we wondered if it would justify skin testing of all patients preoperatively. The Petipain study considers that skin tests should be performed more frequently in order to prevent allergic post-muscle relaxant reactions ( 40 ). Sánchez Palacios considered that testing for all patients was not justified due to the small number of patients who had allergic reactions ( 41 ).…”

Section: Discussionmentioning

confidence: 99%

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Postanesthetic skin erythema due to succinylcholine versus atracurium

et al. 2020

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Intraoperative anaphylactic reactions may range from mild, erythema-like to anaphylactic shock, with tension crash and bronchospasm. The substances considered to be most responsible for the occurrence of intraoperative allergic reactions are neuromuscular blocking agents, antibiotics and latex. Recent studies have identified a new receptor, Mas-Related G-Protein-coupled Receptor X2 (MRGPRX2), considered as a target for some neuromuscular blockers such as atracurium, rocuronium or fluoroquinolone, resulting in pseudoallergic or anaphylactoid reactions. Induction of anesthesia can use both depolarizing myorelaxants, useful especially in emergency situations, in the patient with gastric plenitude or at high risk of intubation, and non-depolarizing myorelaxants such as atracurium, cisatracurium and rocuronium. Succinylcholine has a short time of action and it is rapidly metabolized. Atracurium, although having a slightly longer time to action, has the benefit of a low risk of increased levels of potassium in blood, which is extremely important in patients with cardiac pathology or associated kidney diseases. The present study compared the side effects of systemic anesthesia with succinylcholine vs. atracurium.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Postanesthetic skin erythema due to succinylcholine versus atracurium

et al. 2020

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“…The most common side effects associated with histamine release are flushing and erythema. Less commonly, more severe adverse effects can occur and include tachycardia, bradycardia, hypotension, dyspnea, bronchospasm, urticaria, laryngospasm or wheezing 12 . Studies have previously demonstrated that a MAP fall of 30mmHg can be seen within 2 minutes of administration.…”

Section: S847mentioning

confidence: 99%

Comparison Between Hemodynamic Changes of Atracurium and Cisatracurium in Patients Undergoing Cabg Surgery

Ali

Hussain

Siddiqi

et al. 2021

PAFMJ

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Objective: To compare the hemodynamic effects of Atracurium versus Cisatracurium in Cardiac Patients Undergoing coronary artery bypass graft Surgery. Study Design: Randomized controlled trial. Place and Duration of Study: The study was conducted at Armed Forces Institute of Rawalpindi, a tertiary care hospital, after seeking hospital ethics committee permission, from Apr 2019 to Oct 2019. Methodology: A total of 200 consecutive patients were randomized into two equal groups, group-A and group-C (100 in each group). Group-A patients were induced with 0.5mg/kg of Atracurium, followed by infusion @ 10μg/kg/min whereas group C patients received Cisatracurium @ 0.2mg/kg at induction, followed by infusion @ 2μg/kg/min during the maintainence phase. Systolic blood pressure, diastolic blood pressure, Mean arterial pressure and heart rate were noted at different intervals of both groups. Decrease in systolic blood pressure of >20% from baseline or a value <90 mmHg was considered as hypotension. Results: The mean age of patients was 57.5 ± 6.75 years and 56.52 ± 4.46 years in group A and group C respectively. Systolic and diastolic blood pressure was better maintained with cisatracurium than atracurium. Also Mean arterial pressure remained more stable with cisatracurium (p<0.05), but after opening of sternum and before going on cardiopulmonary bypass, the difference was insignificant in both groups (p>0.05). Heart rate remained more steady with cisatracurium (p<0.05) but had insignificant difference before going on cardiopulmonary bypass (p>0.05). Conclusion: Cisatracurium found to be more suitable drug in maintaining the stable hemodynamics and preventing fluctuations in pressure in cardiac patients undergoing on-pump bypass surgery.

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“…The results and trends of a French pharmacovigilance survey from 2000 to 2012 on neuromuscular blocking agent (NMBA)‐induced anaphylaxis were recently reported . Among all the available drugs in the French pharmacovigilance database, suxamethonium and rocuronium had a 10‐fold higher risk of perioperative anaphylaxis compared to the other NMBAs.…”

Section: Drug Allergymentioning

confidence: 99%

Food and drug allergy, and anaphylaxis in EAACI journals (2018)

Eigenmann

Akdiş²,

Bousquet

et al. 2019

Pediatric Allergy Immunology

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The European Academy of Allergy and Clinical Immunology (EAACI) supports three journals: "Allergy," "Pediatric Allergy and Immunology (PAI)," and "Clinical and Translational Allergy (CTA)." One of the major goals of EAACI is to support health promotion in which prevention of allergy and asthma plays a critical role and to disseminate the knowledge of allergy to all stakeholders including the EAACI junior members. This paper summarizes the achievements of 2018 in anaphylaxis, and food and drug allergy. Main topics that have been focused are anaphylaxis, mechanisms of food allergy (FA), epidemiology of FA, food allergens, diagnosis of FA, prevention and control of FA, FA immunotherapy, drug allergy, and political agenda. K E Y W O R D S allergy, anaphylaxis, Clinical and Translational Allergy, drug allergy, European Academy of Allergy and Clinical Immunology, food allergy, hypersensitivity, Pediatric Allergy and Immunology

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Neuromuscular blocking agents induced anaphylaxis: Results and trends of a French pharmacovigilance survey from 2000 to 2012

Abstract: Suxamethonium and rocuronium are markedly more involved in perioperative anaphylaxis than the other available NMBAs. Patients should be more informed about their perioperative anaphylaxis and its consequences.

Cited by 37 publications

References 41 publications

Postanesthetic skin erythema due to succinylcholine versus atracurium

Postanesthetic skin erythema due to succinylcholine versus atracurium

Comparison Between Hemodynamic Changes of Atracurium and Cisatracurium in Patients Undergoing Cabg Surgery

Food and drug allergy, and anaphylaxis in EAACI journals (2018)

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