Prevention of Allergic Reactions in Anesthetized Patients

Abstract

Hypersensitivity reactions during perioperative period are increasing and may be potentially life-threatening. Therefore, major emphasis is given to prevention. We perform a review to examine which measures should be taken to prevent reactions to products used in elective and emergency surgery. Any patient with a history of previous anaphylaxis or severe reaction during anaesthesia should be referred to allergist for detection of the offending compound. However, the identification of the triggering agent is not always feasible because of the low accuracy of diagnostic tests. In these cases and when emergency surgery is required, it should be considered to replace all drugs administered before the onset of the reaction with alternatives. Furthermore, any cross-reacting agent and latex, especially in patients belonging to populations at-risk for latex allergy should be avoided. In susceptible patients, premedication with antihistamines and corticosteroids might reduce the severity of reaction to drugs or contrast material while it is unclear whether pre-treatment decreases incidence of anaphylactic reactions. There is no evidence that premedication prevents allergic reactions to latex. Overall, physicians should not rely on the efficacy of premedication.

Allergic Reaction Caused by a Lip Balm–Flavored Facemask Used During Inhalational Induction: A Case Report

“…Hypersensitivity or allergic reactions during the perioperative period are increasing and can be potentially life threatening. 5 It has been reported that these reactions are more common in atopic patients. 6 This is in keeping with our patient’s history of atopic disease, including asthma, allergic rhinitis, eosinophilia, and food allergy that may have increased his risk of having an allergic drug reaction.…”

Anaphylactic reaction 5 minutes after the start of surgery: a case report

“…Caffarelli et al advised against relying on premedication because of the lack of documented evidence on its effectiveness in preventing allergic reactions to natural latex rubber [16]. The cost of extensive pre-surgery screening is also not justified for every patient [17].…”

Potential prophylactic efficacy of mast cell stabilizers against COVID-19 vaccine-induced anaphylaxis

“…Regarding the prevention of anaphylaxis, some studies recommended the prophylactic use of these drugs [ 21 , 22 ]. Nevertheless, the results have been controversial or the benefits were limited to the allergic reaction caused by anesthetic agents [ 23 ]. In previous studies, by quantifying the amount of histamine released from mast cells, inhibitory effects of drugs or substances on the activity of mast cells were indirectly determined [ 24 , 25 ].…”