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Anaphylaxis during anesthesia: results of a 12-year survey at a French pediatric center

C Karila1, D Brunet-Langot, F Labbez

  • 1Service de Pneumologie et d'Allergologie Pédiatriques, Hopital Necker-Enfants Malades, Paris Cedex, France.

Allergy
|May 7, 2005
PubMed

Insights

Skin tests for anesthesia hypersensitivity are safe and effective in children. Neuromuscular blocking agents and latex were the most common causes of allergic reactions, improving future anesthetic safety.

Area of Science:

  • Anesthesiology
  • Pediatric Allergy
  • Clinical Immunology

Background:

  • Adverse reactions to anesthesia necessitate diagnostic testing to identify causative agents.
  • Limited French data exists on pediatric skin testing for anesthetic hypersensitivity.

Purpose of the Study:

  • To assess the safety and efficacy of skin testing for diagnosing hypersensitivity reactions to general anesthesia in children.
  • To identify common allergens responsible for anaphylaxis in pediatric anesthesia.

Main Methods:

  • A cohort of 68 children experiencing hypersensitivity reactions to general anesthesia between 1989 and 2001 were evaluated.
  • Diagnosis of immunoglobulin E (IgE)-mediated anaphylaxis was based on skin tests and clinical history.

Main Results:

  • IgE-mediated anaphylaxis was diagnosed in 51 children, with neuromuscular blocking agents (NMBAs) being the most frequent cause (60.8%), followed by latex (27%).
  • Cross-reactivity among NMBAs was observed in 76% of affected children.
  • The estimated frequency of IgE-mediated anaphylactic reactions was 1 in 2100 operations.

Conclusions:

  • Neuromuscular blocking agents and latex are primary culprits for anaphylactic reactions during pediatric anesthesia.
  • Skin testing for anesthetic agents is confirmed as a safe and feasible diagnostic tool in children.
  • These tests enhance the safety of subsequent anesthetic procedures for pediatric patients.
Abstract

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