Exploring the Landscape of Perioperative Immediate Hypersensitivity: A Comprehensive 6-Year Monocentric Observational...

Perioperative immediate hypersensitivity (POH) is a rare complication estimated at 1/10,000 anaesthesia. The objective of our study was to investigate the risk factors of POH over a 6-year period in a French teaching hospital.

A single-centre retrospective descriptive epidemiological study of patients treated in the operating room from January 2016 to December 2021 with and without POH.

111 POH were identified out of 47,585 surgeries, mainly women (71%) with a history of asthma (16% vs. 6%, p < 0.001) undergoing plastic surgery (49% vs. 32%, p < 0.001). POH patients were more likely to receive neuromuscular blocking agents and antibiotics (respectively, 88% vs. 59%, p < 0.001 and 59% vs. 24%, p < 0.001). 92% of patients underwent intraoperative sampling, only 31% benefited from an allergy consultation. 14% had positive skin test (ST). The culprit agent were neuromuscular blocking agents (47% of which 57% rocuronium, 29% suxamethonium, and 14% atracurium), antibiotics (33%, of which 80% cefazolin and 20% cefoxitin), and gelatin (7%).

Our study reported a POH incidence of 23/10,000 anaesthesia, with identified allergens aligning with existing literature. These findings underscore the critical need for enhanced patient follow-up to monitor potential hypersensitivity and mitigate future risks.