title: Anaphylactic bronchospasm during general anesthesia is not related to asthma.
abstract: In the general population, a history of asthma (HA) is associated with a higher risk of mortality of anaphylactic shock (AS), but it is unknown whether this association remains valid for intra-operative AS. The goal of this retrospective study was to investigate whether a HA was associated with a higher risk of bronchospasm during intra-operative AS. We analyzed 106 patients (January 2009-December 2012) with intra-operative AS: 57% of them had a confirmed IgE-mediated reaction and 27% had a HA. On logistic regression, the only factor statistically associated with bronchospasm was a neuromuscular blocking drug, with both IgE- or non-IgE-mediated reactions. These results suggest that the mechanisms of bronchospasm in AS may be different from those of asthma and that, in the presence of bronchospasm during anesthesia, AS should be considered to be the most likely cause.
authors.affiliation: Département d'Anesthésie-Réanimation, Hôpital Bichat-Claude Bernard, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Gouel-Chéron
authors.forename: C
authors.initials: C
authors.lastname: Neukirch
authors.forename: B
authors.initials: B
authors.lastname: Aubier
authors.forename: P
authors.initials: P
authors.lastname: Montravers
authors.forename: P
authors.initials: P
authors.lastname: Nicaise
authors.forename: S
authors.initials: S
authors.lastname: Chollet-Martin
authors.forename: P-M
authors.initials: PM
authors.lastname: Mertes
authors.forename: M
authors.initials: M
authors.lastname: Aubier
authors.forename: D
authors.initials: D
authors.lastname: Longrois
mesh_terms: D000328:Adult; D000368:Aged; D000707:Anaphylaxis / Q000209:etiology* / Q000503:physiopathology*; D000768:Anesthesia, General / Q000009:adverse effects*; D001249:Asthma / Q000150:complications*; D001986:Bronchial Spasm / Q000209:etiology*; D004342:Drug Hypersensitivity; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies
chemical_list: D007073:Immunoglobulin E
keywords: anaphylaxis; asthma; atopy; bronchospasm; general anesthesia