Perioperative allergic reactions: Experience in a Flemish referral centre

Antunes, João; Kochuyt, Anne-Marie; Ceuppens, Jan L.

doi:10.1016/j.aller.2013.08.001

Cited by 56 publications

(43 citation statements)

References 27 publications

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“…It would be useful to separate the administration of the prophylactic antibiotic therapy and anaesthetic induction in order to identify and treat the reaction as early as possible. Betalactams are responsible for 70% of reactions due to antibiotics [20], especially cephalosporins [5], being cefazolin the most frequent causal agent in Spain [66]. Vancomycin is the second most common antibiotic involved, although reactions are almost always due to a non-immunological mechanism [67].…”

Section: A) Drugsmentioning

confidence: 99%

Practical Guidelines for Perioperative Hypersensitivity Reactions

Laguna¹,

Archilla²,

Doña³

et al. 2018

J Investig Allergol Clin Immunol

105

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Perioperative hypersensitivity reactions constitute a first-line problem for anesthesiologists and allergists, so it is advisable that hospitals have a consensus protocol for the diagnosis and management of these reactions. However, this kind of protocols is not present in many hospitals, leading to problems in treatment, the communication of incidents and subsequent etiological diagnosis. In this document we present a systematic review of the available scientific evidence and provide general guidelines for the management of acute episodes and Resumen:Las reacciones de hipersensibilidad perioperatorias constituyen un problema de primera línea para los anestesiólogos y alergólogos, por lo que es recomendable que los hospitales tengan un protocolo de consenso para el diagnóstico y el tratamiento de estas reacciones. Sin embargo, este tipo de protocolos no está presente en muchos hospitales, lo que conlleva problemas en el tratamiento, la comunicación de incidentes y el posterior diagnóstico etiológico. Este documento ha sido creado por miembros del Comité de Alergia a Medicamentos de la Sociedad Española de Alergia e Inmunología Clínica (SEAIC) en colaboración con miembros de la Sociedad Española de Anestesia (SEDAR). Se ha realizado una revisión sistemática de la evidencia científica disponible y se proporcionan pautas generales para el manejo de episodios agudos y para la derivación de pacientes con reacciones de hipersensibilidad perioperatoria a los Servicios de Alergología. Se propone un algoritmo práctico para el diagnóstico etiológico y se brindan recomendaciones para el manejo de pacientes con reacciones alérgicas perioperatorias.

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Section: A) Drugsmentioning

confidence: 99%

Practical Guidelines for Perioperative Hypersensitivity Reactions

Laguna¹,

Archilla²,

Doña³

et al. 2018

J Investig Allergol Clin Immunol

105

View full text Add to dashboard Cite

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“…The proportion of patients in our study for whom no causative agent could be determined was comparable to those in other reports. [12][13][14] Among the 21 patients who suffered anaphylaxis during anaesthesia and the cause was subsequently identified, antibiotics were the most common causative agent (52.3%), followed by NMBAs (38.1%), opioids (4.8%) and gelofusine (4.8%). In contrast, data from 4000 patients reported by Mertes et al indicated that NMBAs accounted for 63% of reactions, followed by latex (14%), hypnotics (7%), antibiotics (6%), plasma substitutes (3%) and opioids (2%).…”

Section: Discussionmentioning

confidence: 99%

Anaphylaxis during general anaesthesia: experience from a drug allergy centre in theUK

Meng

Rotiroti

Burdett

et al. 2017

Acta Anaesthesiol Scand

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BackgroundAnaphylaxis during general anaesthesia is rare but often severe. Identification of the cause of anaphylaxis and recommendation of a range of drugs or agents likely to be safer for future surgery is a collaborative venture between the allergists and the anaesthesiologists, but it often poses a significant challenge.MethodsA total of 31 patients who attended the Drug Allergy Unit at University College London Hospital with suspected perioperative anaphylaxis between March 2013 and January 2016 were reviewed retrospectively.ResultsThe culprit drug was identified in 21 patients (67.7%): antibiotics (n = 11, 52.3%), neuromuscular blocking agents (n = 8, 38.1%), morphine (n = 1, 4.8%) and gelofusine (n = 1, 4.8%). No cause was identified in six patients (19.4%), and four patients (12.9%) had non‐allergic reactions.ConclusionOur results confirm that antibiotics and neuromuscular blocking agents are common causative agents of perioperative anaphylaxis in the United Kingdom.

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“…The presence of this enzyme is therefore a key element in diagnosing anaphylactic reactions [19]. However, the optimum number of Tryptase measurements and the best interpretative strategy has not yet been established in perioperative anaphylaxis [20][21][22]. Our internal protocol for Anaphylaxis in the perioperative period includes a proposal for Tryptase measurements.…”

Section: Discussionmentioning

confidence: 99%

Hypersensitivity Reactions During Anaesthesia Care: An 11-Year Experience From A Tertiary Hospital

Pereira¹,

Almeida²,

Frada³

et al. 2017

J Anesth Clin Res

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Introduction: Anaphylaxis during general anaesthesia is a rare but life-threatening clinical condition involving multiple organ systems, with a reported incidence of 1 in 4.000 to 25.000 anesthetic procedures. The objective of this study is to describe the experience of a Tertiary University Hospital with drug hypersensitivity reactions, including anaphylaxis, during anaesthesia care, their main causal agents, treatment and investigation.

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Perioperative allergic reactions: Experience in a Flemish referral centre

Abstract: NMBA, antibiotics, latex and chlorhexidine were the main culprits of IgE-mediated perioperative reactions. Uncertainties remain concerning the specificity and sensitivity of skin testing. Tryptase assays can be useful in the discrimination of IgE and non-IgE-mediated reactions.

Cited by 56 publications

References 27 publications

Practical Guidelines for Perioperative Hypersensitivity Reactions

Practical Guidelines for Perioperative Hypersensitivity Reactions

Anaphylaxis during general anaesthesia: experience from a drug allergy centre in theUK

Hypersensitivity Reactions During Anaesthesia Care: An 11-Year Experience From A Tertiary Hospital

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