[Mastocytosis. A challenge in anaesthesiology].
Mastocytosis is a general term for a heterogeneous group of rare disorders. Many agents used in anaesthesia can trigger mast cell degranulation with release of histamine, prostaglandin, tryptase and heparin. Therefore, patients with mastocytosis are high-risk patients when undergoing anaesthesia. The management of these patients in anaesthesia will be discussed on the basis of the literature and illustrated with the discussion of three case reports. A premedication with antihistamines and a glucocorticoid is recommended. For induction of general anaesthesia propofol, etomidate, ketamine, a fentanyl-type opioid, cis-atracurium or pancuronium are recommended. Anaesthesia can be maintained either by a total intravenous technique or with a volatile anaesthetic such as sevoflurane.
Klinik für Anaesthesiologie und Intensivmedizin, Universitätsklinikum Tübingen.
F M
FM
Konrad
K E
KE
Unertl
T H
TH
Schroeder
D000758:Anesthesia; D000768:Anesthesia, General; D000769:Anesthesia, Inhalation; D000771:Anesthesia, Intravenous; D000777:Anesthetics / Q000009:adverse effects*; D006348:Cardiac Surgical Procedures; D006633:Histamine Antagonists / Q000627:therapeutic use; D006801:Humans; D007044:Hysterectomy; D007223:Infant; D007249:Inflammation / Q000150:complications / Q000628:therapy; D008297:Male; D008415:Mastocytosis / Q000150:complications* / Q000503:physiopathology; D034701:Mastocytosis, Cutaneous / Q000150:complications / Q000503:physiopathology; D034721:Mastocytosis, Systemic / Q000150:complications / Q000503:physiopathology; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D011292:Premedication; D013771:Tetralogy of Fallot / Q000601:surgery; D014068:Tonsillectomy
D000777:Anesthetics; D006633:Histamine Antagonists