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Practical guidelines for the response to perioperative anaphylaxis.

Tomonori Takazawa1, Ken Yamaura2, Tetsuya Hara3

  • 1Intensive Care Unit, Gunma University Hospital, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan. takazawt@gunma-u.ac.jp.

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Perioperative anaphylaxis, a severe allergic reaction during anesthesia, necessitates prompt recognition and management. Muscle relaxants, antibiotics, and sugammadex are common triggers, requiring careful patient history and diagnosis for effective treatment.

Keywords:
AnaphylaxisAnesthesiaGuidelineShock

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Area of Science:

  • Anesthesiology
  • Clinical Immunology
  • Pharmacology

Background:

  • Perioperative anaphylaxis is a critical adverse event during anesthesia.
  • Muscle relaxants, antibiotics, and sugammadex are frequent culprits.
  • Identifying causative agents is crucial for preventing recurrence.

Purpose of the Study:

  • To provide a practical guide for preventing, diagnosing, and treating anaphylaxis during anesthesia.
  • To assist anesthesiologists in managing this severe adverse event.
  • To improve early detection and management strategies.

Main Methods:

  • Review of current research on perioperative anaphylaxis.
  • Development of diagnostic and treatment recommendations.
  • Guidance on identifying causative agents through skin and in vitro tests.

Main Results:

  • Anaphylaxis diagnosis can be challenging due to masked symptoms under surgical drapes.
  • Persistent hypotension resistant to vasopressors suggests anaphylaxis.
  • Intravenous adrenaline is the first-line treatment, with careful dosage selection crucial.

Conclusions:

  • Early recognition and prompt treatment with adrenaline are vital.
  • Identifying the causative agent aids in future prevention.
  • This guideline aims to enhance the management of anaphylaxis in the perioperative setting.