Quelle est la réalité du risque allergique en anesthésie ? Incidence. Aspects cliniques. Morbidité-mortalité. Substances responsables

Hypersensitivity Reaction to Midazolam

“…Anaphylaxis is the most serious allergic reaction characterized by generalized signs and symptoms that can compromize the vital prognosis and can lead to death in 2% of the cases [1]. The incidence of anaphylactic reactions in France has been evaluated to 1 over 13000 general and loco regional anesthesias [2]. The incidence of allergy during anesthesia in children is 1 over 7741 anesthesia [3].…”

Contact sensitization to quaternium-15 acting as a warning sign for curare allergy

“…Curare‐like compounds are quaternary ammonium salts used as neuromuscular blocking agents (NMBAs) in general anaesthesia. They are responsible for 62% of anaphylactic reactions occuring during anaesthesia, with natural rubber latex proteins being the next most likely cause (1, 2). The chemical structure (3) of curare is critical.…”

Le risque allergique des curares

“…3 Si dans les années 1970 on considérait que les réactions anaphylactoïdes aux curares étaient expliquées par leur effet pharmacologique et pouvaient être prévenues par des antihistaminiques, [4][5][6] on s'est vite aperçu, en pratiquant des investigations allergologiques chez les patients, que la majorité de ces réactions étaient immunologiques, médiées par des IgE spécifiques et qu'il n'existait aucune prémédica-tion efficace. [7][8][9][10][11] À dater de 1980, la France, comme l'Australie, la Nouvelle Zélande et le Royaume Uni, a développé une intense politique d'investigations allergologiques systématiques chez les patients ayant fait une réaction anaphylactoïde peranesthésique.…”

“…3 Although it was thought in the 1970's that anaphylactoid reactions to NMBDs could be explained by their pharmacological effect and that they could be prevented by antihistaminics, 4-6 allergological investigations on patients quickly showed that most of these reactions were immunological, that they were mediated by specific IgE's and that no effective premedication existed. [7][8][9][10][11] Starting in 1980, France, like Australia, New Zealand and the United Kingdom, developed an intensive policy of systematic allergological investigations of patients who had had peranesthetic anaphylactoid reactions.…”