Perioperative anaphylaxis.
The incidence of immune-mediated anaphylaxis during anesthesia ranges from 1 in 10,000 to 1 in 20,000. Neuromuscular blocking agents are most frequently incriminated, followed by latex and antibiotics, although any drug or substance used may be a culprit. Diagnosis relies on tryptase measurements at the time of the reaction and skin tests, specific immunoglobulin E, or basophil activation assays. Treatment consists of rapid volume expansion and epinephrine administration titrated to symptom severity.
Mertes
P M
PM
Service d'Anesthésie-Réanimation Chirurgicale, CHU de Nancy, Hôpital Central, 29 Avenue de Lattre de Tassigny, 54035 Nancy Cedex, France. pm.mertes@chu-nancy.fr
Tajima
K
K
Regnier-Kimmoun
M A
MA
Lambert
M
M
Iohom
G
G
Guéant-Rodriguez
R M
RM
Malinovsky
J M
JM
D000322:Adrenergic Agonists / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000009:adverse effects; D000707:Anaphylaxis / Q000139:chemically induced* / Q000175:diagnosis / Q000276:immunology / Q000628:therapy; D000758:Anesthesia / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D007611:Aprotinin / Q000009:adverse effects; D001491:Basophils / Q000276:immunology; D004837:Epinephrine / Q000627:therapeutic use; D005440:Fluid Therapy; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects; D007073:Immunoglobulin E / Q000032:analysis / Q000276:immunology; D007431:Intraoperative Complications / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D007840:Latex / Q000009:adverse effects / Q000633:toxicity*; D009466:Neuromuscular Blocking Agents / Q000009:adverse effects*; D012307:Risk Factors; D015842:Serine Proteinase Inhibitors / Q000009:adverse effects; D012882:Skin Tests; D053802:Tryptases / Q000032:analysis
D000322:Adrenergic Agonists; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D006993:Hypnotics and Sedatives; D007840:Latex; D009466:Neuromuscular Blocking Agents; D015842:Serine Proteinase Inhibitors; D007073:Immunoglobulin E; D007611:Aprotinin; D053802:Tryptases; D004837:Epinephrine