Allergy and anaphylaxis in anaesthesia

Area of Science:

• Anesthesiology
• Immunology
• Allergy

Background:

• Immediate hypersensitivity reactions during anesthesia are increasing.
• Reactions are often IgE-mediated (anaphylaxis) or anaphylactoid.
• Neuromuscular blocking agents, latex, and antibiotics are common culprits.

Purpose of the Study:

• To investigate the nature and causes of perioperative hypersensitivity reactions.
• To emphasize the need for thorough allergy assessment in high-risk patients.
• To advocate for improved clinical networks in allergo-anesthesiology.

Main Methods:

• Combined peroperative and postoperative testing for suspected reactions.
• Plasma histamine, tryptase, and specific IgE measurements.
• Skin tests conducted six weeks post-reaction.

Main Results:

• Anaphylactic and anaphylactoid reactions are clinically indistinguishable.
• Accurate diagnosis requires extensive allergy investigations.
• No specific treatment reliably prevents anaphylaxis.

Conclusions:

• Suspected anaphylaxis necessitates comprehensive investigation to identify causative agents.
• Allergy assessment is vital for high-risk patients due to lack of preventative treatments.
• Development of allergo-anesthesiology networks is needed for expert guidance.