[Allergic and pseudo-allergic reactions in anesthesia. II: Symptoms, diagnosis, therapy, prevention].
In this article we present the symptomatic features and discuss relevant diagnostic and therapeutic aspects of anaphylactoid reactions. In addition we give practical advice as to how to avoid and manage allergic or pseudoallergic reactions during anaesthesia. Measurements of serum tryptase-levels and of methylhistamine in urine have been introduced in clinical diagnostic routine. Skin tests and determination of specific antibodies are essential to identify responsible substances. Preventive measures like careful premedication, calm atmosphere, slow injection of drugs, the use of diluted solutions, and the use of drugs with a low potential for anaphylactoid reactions are important. Substances like inhalation anaesthetics, propofol, etomidate, ketamine, midazolam, fentanyl, alfentanil and bupivacain without epinephrine should be used.
Theissen
J L
JL
Klinik und Poliklinik für Anästhesiologie und operative Intensivmedizin, Westfälische Wilhelms-Universität Münster.
Zahn
P
P
Theissen
U
U
Brehler
R
R
D000768:Anesthesia, General; D000777:Anesthetics / Q000009:adverse effects*; D053818:Chymases; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000628:therapy; D006633:Histamine Antagonists / Q000008:administration & dosage; D006801:Humans; D007431:Intraoperative Complications / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D008761:Methylhistamines / Q000652:urine; D012307:Risk Factors; D012697:Serine Endopeptidases / Q000097:blood; D053802:Tryptases
D000777:Anesthetics; D006633:Histamine Antagonists; D008761:Methylhistamines; D012697:Serine Endopeptidases; C083294:chymase 2; D053818:Chymases; D053802:Tryptases
Allergische und pseudoallergische Reaktionen in der Anästhesie. Teil II: Symptomatik, Diagnose, Therapie, Prophylaxe.