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Allergic Reactions: Anaphylaxis01:30

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Anaphylaxis is a severe, life-threatening hypersensitivity reaction mediated by Immunoglobulin E (IgE) antibodies. When IgE binds to allergens, it triggers the release of mediators– histamine, leukotrienes, and prostaglandins from mast cells and basophils. These mediators cause vasodilation, edema, and inflammation, leading to various symptoms.The primary allergens causing anaphylaxis include food items (e.g., peanuts, shellfish), drugs (e.g., penicillin, asparaginase, corticotropin,...
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General Anesthesia: Overview01:24

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Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
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Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
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Anaphylaxis during anaesthesia: Indian scenario.

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Indian Journal of Anaesthesia
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Anaphylaxis during anesthesia is a significant concern in India, with two-thirds of surveyed anesthesiologists reporting cases. Opioids and muscle relaxants were common culprits, alongside non-anesthetic drugs, highlighting a need for better allergy testing and referral centers.

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Anaesthesiaanaphylaxissurvey

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Area of Science:

  • Anesthesiology
  • Immunology
  • Public Health

Background:

  • Anaphylaxis during anesthesia is a rare but severe complication.
  • India lacks a centralized database for perianaesthetic anaphylaxis.
  • This study addresses the knowledge gap regarding anaphylaxis incidence and causes in India.

Purpose of the Study:

  • To determine the incidence of anaphylaxis during anesthesia in India.
  • To identify the etiological agents responsible for anaphylaxis during anesthesia.
  • To assess the current practices and resources for managing anaphylaxis in India.

Main Methods:

  • A 20-item questionnaire was distributed to 600 randomly selected Indian anesthesiologists.
  • Responses were collected electronically or in person and subsequently analyzed.
  • The survey focused on experienced cases, implicated agents, and diagnostic testing availability.

Main Results:

  • 67% of respondents (242 total) reported witnessing anaphylaxis during anesthesia.
  • Anesthetic drugs (40%) and non-anesthetic drugs (60%) were implicated; opioids and non-depolarizing muscle relaxants were most common anesthetic agents.
  • Five deaths occurred; allergy testing was underutilized despite availability, and referral centers were scarce.

Conclusions:

  • Anaphylaxis during anesthesia is frequently encountered by Indian anesthesiologists.
  • Opioids, non-depolarizing muscle relaxants, colloids, antibiotics, and blood transfusions are key triggers.
  • There is a critical need to improve allergy testing utilization and access to specialized referral centers for anaphylaxis management in India.