Anaphylaxis during general anaesthesia: experience from a drug allergy centre in the UK.
BACKGROUND
Anaphylaxis during general anaesthesia is rare but often severe. Identification of the cause of anaphylaxis and recommendation of a range of drugs or agents likely to be safer for future surgery is a collaborative venture between the allergists and the anaesthesiologists, but it often poses a significant challenge.


METHODS
A total of 31 patients who attended the Drug Allergy Unit at University College London Hospital with suspected perioperative anaphylaxis between March 2013 and January 2016 were reviewed retrospectively.


RESULTS
The culprit drug was identified in 21 patients (67.7%): antibiotics (n = 11, 52.3%), neuromuscular blocking agents (n = 8, 38.1%), morphine (n = 1, 4.8%) and gelofusine (n = 1, 4.8%). No cause was identified in six patients (19.4%), and four patients (12.9%) had non-allergic reactions.


CONCLUSIONS
Our results confirm that antibiotics and neuromuscular blocking agents are common causative agents of perioperative anaphylaxis in the United Kingdom.
Otolaryngology Department, West China Hospital, Sichuan University, Chengdu, China.|Department of Specialist Allergy and Clinical Immunology, Royal National Throat Nose Ear Hospital, University College London Hospital, London, UK.
J
J
Meng
Department of Specialist Allergy and Clinical Immunology, Royal National Throat Nose Ear Hospital, University College London Hospital, London, UK.
G
G
Rotiroti
Department of Anaesthetics, University College London Hospital, London, UK.
E
E
Burdett
Department of Specialist Allergy and Clinical Immunology, Royal National Throat Nose Ear Hospital, University College London Hospital, London, UK.|Department of Imaging Sciences, King's College London, London, UK.
J J
JJ
Lukawska
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000707:Anaphylaxis / Q000209:etiology*; D000768:Anesthesia, General / Q000009:adverse effects*; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D004342:Drug Hypersensitivity / Q000209:etiology*; D005260:Female; D006801:Humans; D020315:Latex Hypersensitivity / Q000150:complications; D008297:Male; D008875:Middle Aged; D009466:Neuromuscular Blocking Agents / Q000009:adverse effects; D012189:Retrospective Studies; D012882:Skin Tests
D000900:Anti-Bacterial Agents; D009466:Neuromuscular Blocking Agents