[Incidence and clinical features of anaphylaxis during general anesthesia].
BACKGROUND
Anaphylaxis is an acute life-threatening systematic reaction, and it requires early diagnosis and correct management to save the patients. The true incidence of anaphylaxis during general anesthesia is unknown. Although anaphylaxis is a rare intraoperative complication, most drugs used in the perioperative period can lead to anaphylaxis.


METHODS
All patients who had received operations under general anesthesia in our hospital were covered in this study during the 5-year period. We searched for the incidence and clinical features of anaphylaxis retrospectively.


RESULTS
Seven cases in 9,844 patients were recognized. Various drugs were suspected as causal agents, but they were all nonanesthesia related drugs. The diagnosis of anaphylaxis relied on the history and clinical course of each patient. There was no reliable diagnostic testing such as serum tryptase and skin test. So we could not determine whether the reaction was IgE-mediated or not.


CONCLUSIONS
Immediate discontinuation of causal drugs and early administration of epinephrine are cornerstones of treatment. More specific diagnostic tests are required for correct identification of causal drugs. To reduce the risk of anaphylaxis during anesthesia, we hope practical data bases and guidelines for anaphylaxis related to anesthesia will be published in the future.
Nabatame
Maki
M
Department of Anesthesiology, Hoshigaoka Koseinenkin Hospital, Hirakata 108-8616.
Mori
Masanobu
M
Ikeda
Yoshikazu
Y
Matsushita
Mitsuji
M
Tsujimura
Shigehisa
S
D000293:Adolescent; D000328:Adult; D000707:Anaphylaxis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D000768:Anesthesia, General; D015415:Biomarkers / Q000097:blood; D002648:Child; D003937:Diagnosis, Differential; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015994:Incidence; D007431:Intraoperative Complications / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D053802:Tryptases / Q000097:blood
D015415:Biomarkers; D053802:Tryptases; D004837:Epinephrine