Suspected Anaphylactic Reactions Associated with Anaesthesia

Harper, N.J.N.; Dixon, T. A.; Dugué, Pierre Antoine; Edgar, J. D. M.; Fay, A; Gooi, H. C.; Herriot, Richard; Hopkins, Philip M.; Hunter, Jennifer M.; Mirakian, Rita; Pumphrey, R. S. H.; Seneviratne, Suranjith L.; Walls, Andrew F.; Williams, Paul; Wildsmith, J.A.W.; Wood, Philip; Nasser, A S; Powell, R K; Mirakhur, R. K.; Soar, Jasmeet

doi:10.1111/j.1365-2044.2008.05733.x

Cited by 289 publications

(169 citation statements)

References 25 publications

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“…This classification describes four grades of increasing severity: I; cutaneous-mucous signs (e.g. urticaria), II; moderate multivisceral signs (involvement Tachycardia and hypotension are usually observed, though bradycardia (resulting from the Bezold-Jarisch reflex) may occur in up to 10% of cases during general anaesthesia (Dewachter et al 2009, Harper et al 2009, Kroigaard et al 2007). …”

Section: Discussionmentioning

confidence: 99%

“…Perioperative anaphylaxis in humans is uncommon, with an estimated incidence of 1 in 10,000 to 20,000 anaesthetics, but carries a mortality rate of around 4-10% (Axon and Hunter 2004, Dewachter et al 2009, Gibbs et al 2013, Harper et al 2009, Reitter et al 2014. From the limited number of published veterinary reports it is impossible to ascertain a mortality rate.…”

Section: Discussionmentioning

confidence: 99%

“…Anaphylaxis, defined by the World Allergy Organization as "a severe, life-threatening generalised or systemic hypersensitivity reaction" (Johansson et al 2004) occurs uncommonly perioperatively, with an incidence in humans of 1 in 10,000 to 20,000 anaesthetics (Dewachter et al 2009, Harper et al 2009). However, it is associated with a high mortality rate of approximately 4-10% (Axon and Hunter 2004, Gibbs et al 2013, Reitter et al 2014).…”

Section: Introductionmentioning

confidence: 99%

“…The most common triggers of anaphylaxis in human anaesthesia are neuromuscular blocking agents (NMBAs), latex and antibiotics (Dewachter et al 2009, Harper et al 2009, Mertes et al 2003. Limited reports in the veterinary literature preclude identifying common triggers.…”

Section: Introductionmentioning

confidence: 99%

“…Treatment is based on addressing cardiovascular collapse, impaired ventilation and oxygenation, relative hypovolaemia, and removing potential causative agents (Dewachter et al 2009, Harper et al 2009, Simons et al 2011, Simons et al 2013. However, despite well-established evidence-based guidelines for treating anaphylaxis with epinephrine as a first line therapy, compliance is poor (Choo et al 2012, Grabenhenrich et al 2012.…”

Section: Introductionmentioning

confidence: 99%

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Suspected anaphylaxis from intravenous cefazolin during general anaesthesia in a dog

Prebble¹,

Pang

2016

Preprint

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A 6-year-old female Shetland Sheepdog with a history of cardiorespiratory compromise during general anaesthesia was referred for ovariohysterectomy surgery. Clinical examination was unremarkable at presentation and physiologic parameters under general anaesthesia were within expected ranges during preparation for surgery. Shortly after completion of an intravenous injection of cefazolin, the audible signal from the Doppler ultrasound unit stopped. A rapid survey of the patient revealed tachycardia with weak femoral pulses, tachypnoea, hyperpnoea and substantially increased resistance to manual positive pressure ventilation. Stopping inhalant anaesthesia, administering salbutamol, corticosteroids and diphenhydramine were associated with resolution of clinical signs. However, marked hypotension and resistance to ventilation recurred approximately 25 minutes later. Low dose intravenous epinephrine (5 mcg/kg) was effective at increasing arterial blood pressure and reversing respiratory dysfunction. Surgery was completed and the patient recovered uneventfully. Initial reliance on second line therapy and delay in administering epinephrine, the recommended treatment for anaphylaxis, may have slowed resolution of clinical signs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Suspected anaphylaxis from intravenous cefazolin during general anaesthesia in a dog

Prebble¹,

Pang

2016

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A Nanocage for Nanomedicine: Polyhedral Oligomeric Silsesquioxane (POSS)

Ghanbari

Cousins

Seifalian

2011

Macromol. Rapid Commun.

256

141

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Ground-breaking advances in nanomedicine (defined as the application of nanotechnology in medicine) have proposed novel therapeutics and diagnostics, which can potentially revolutionize current medical practice. Polyhedral oligomeric silsesquioxane (POSS) with a distinctive nanocage structure consisting of an inner inorganic framework of silicon and oxygen atoms, and an outer shell of organic functional groups is one of the most promising nanomaterials for medical applications. Enhanced biocompatibility and physicochemical (material bulk and surface) properties have resulted in the development of a wide range of nanocomposite POSS copolymers for biomedical applications, such as the development of biomedical devices, tissue engineering scaffolds, drug delivery systems, dental applications, and biological sensors. The application of POSS nanocomposites in combination with other nanostructures has also been investigated including silver nanoparticles and quantum dot nanocrystals. Chemical functionalization confers antimicrobial efficacy to POSS, and the use of polymer nanocomposites provides a biocompatible surface coating for quantum dot nanocrystals to enhance the efficacy of the materials for different biomedical and biotechnological applications. Interestingly, a family of POSS-containing nanocomposite materials can be engineered either as completely non-biodegradable materials or as biodegradable materials with tuneable degradation rates required for tissue engineering applications. These highly versatile POSS derivatives have created new horizons for the field of biomaterials research and beyond. Currently, the application of POSS-containing polymers in various fields of nanomedicine is under intensive investigation with expectedly encouraging outcomes.

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Current awareness: Pharmacoepidemiology and drug safety

2009

Pharmacoepidemiology and Drug

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of pharmacoepidemiology and drug safety. Each bibliography is divided into 23 sections: 1 Reviews; 2 General; 3 Anti‐infective Agents; 4 Cardiovascular System Agents; 5 CNS Depressive Agents; 6 Non‐steroidal Anti‐inflammatory Agents; 7 CNS Agents; 8 Anti‐neoplastic Agents; 9 Haematological Agents; 10 Neuroregulator‐Blocking Agents; 11 Dermatological Agents; 12 Immunosuppressive Agents; 13 Autonomic Agents; 14 Respiratory System Agents; 15 Neuromuscular Agents; 16 Reproductive System Agents; 17 Gastrointestinal System Agents; 18 Anti‐inflammatory Agents ‐ Steroidal; 19 Teratogens/fetal exposure; 20 Antidiabetic Agents; 21 Contrast Agents; 22 Bone Conservation Agents; 23 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted.

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Suspected Anaphylactic Reactions Associated with Anaesthesia

Cited by 289 publications

References 25 publications

Suspected anaphylaxis from intravenous cefazolin during general anaesthesia in a dog

Suspected anaphylaxis from intravenous cefazolin during general anaesthesia in a dog

A Nanocage for Nanomedicine: Polyhedral Oligomeric Silsesquioxane (POSS)

Current awareness: Pharmacoepidemiology and drug safety

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