title: [Postoperative allergic complications: the role of the anesthetist in conducting the immuno-allergic investigation].
abstract: When peri-anaesthesia anaphylactic and/or anaphylactoid reactions occur, anaesthetist is the first investigator: the quality of immuno-allergological investigations depends on these initial investigational procedures. We have used sample kits for several years in order to make easier the immediate investigation. From retrospective analysis of the allergic complications which happened in 1997, the importance of these sample kits as well as the anaesthetist's part in the immuno-allergological management are examined. Nine observations were itemized (0.047%): 3 generalized erythema observations (grade I), in which atracurium was incriminated twice, and propacetamol once; 2 observations of grade II, in which vecuronium (elevated tryptase) and atracurium were incriminated; 4 anaphylactic shocks, in which three neuromuscular blocking drugs (suxamethonium, vecuronium and pancuronium), and one antibiotic (cloxacilline) were incriminated. The use of sample kits allowed an early diagnosis approach, confirmed by skin tests. Diagnosis should be thought closely between anaesthetists and immunologists for investigations.
authors.affiliation: Département d'Anesthésie-Réanimation Chirurgicale B-C.H.U., Angers, France.
authors.forename: C
authors.initials: C
authors.lastname: Cottineau
authors.forename: J G
authors.initials: JG
authors.lastname: Bukowski
authors.forename: L B
authors.initials: LB
authors.lastname: Subayi
authors.forename: S
authors.initials: S
authors.lastname: Hassoun
authors.forename: M
authors.initials: M
authors.lastname: Drouet
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000707:Anaphylaxis / Q000139:chemically induced / Q000175:diagnosis / Q000276:immunology*; D000758:Anesthesia / Q000009:adverse effects*; D000762:Anesthesia Recovery Period; D000776:Anesthesiology; D053818:Chymases; D005260:Female; D006632:Histamine / Q000097:blood; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D008297:Male; D008875:Middle Aged; D010819:Physician's Role; D011183:Postoperative Complications / Q000139:chemically induced / Q000175:diagnosis / Q000276:immunology*; D011933:Reagent Kits, Diagnostic; D012189:Retrospective Studies; D012697:Serine Endopeptidases / Q000097:blood; D012882:Skin Tests; D053802:Tryptases
chemical_list: D018836:Inflammation Mediators; D011933:Reagent Kits, Diagnostic; D006632:Histamine; D012697:Serine Endopeptidases; C083294:chymase 2; D053818:Chymases; D053802:Tryptases
vernacular_title: Complications allergiques péri-opératoires: rôle du médecin Anesthésiste-Réanimateur dans la conduite du bilan immuno-allergique.