Related Experiment Videos
Anaphylaxis during surgical and interventional procedures.
Bernard Yu-Hor Thong1, Yeow-Chan
1Department of Rheumatology, Allergy, and Immunology, Tan Tock Seng Hospital, Singapore. bernard_thong@ttsh.com.sg
Summary
Anaphylaxis during surgery is often caused by neuromuscular blocking agents, latex, and antibiotics. Diagnosis requires careful review of anesthetic records and testing for various agents.
Area of Science:
- Anesthesiology
- Immunology
- Pharmacology
Background:
- Anaphylaxis during surgical and interventional procedures presents unique diagnostic challenges due to the rapid administration of multiple agents.
- Identifying causative agents is crucial for patient safety and future management.
Purpose of the Study:
- To review current evidence on the causes, diagnosis, and treatment of anaphylaxis related to surgical and interventional procedures.
- To provide guidance on evaluating and managing these hypersensitivity reactions.
Main Methods:
- A comprehensive literature search was conducted using MEDLINE (1966-2003) and article reference lists.
- Included were relevant, peer-reviewed original research articles and reviews.
Main Results:
- Common causes include neuromuscular blocking agents, natural rubber latex, antibiotics, and induction agents.
- Radiocontrast media, colloids, and opioids account for fewer than 10% of reactions.
- Skin testing, IgE measurements, and flow cytometry show promise for diagnosis; drug desensitization and premedication are treatment strategies.
Conclusions:
- Evaluating anaphylaxis in surgical settings is complex due to polypharmacy.
- Thorough analysis of anesthetic records and diagnostic testing are essential for accurate assessment.