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神经肌肉阻断剂在回顾性队列中的再暴露与神经肌肉阻断剂相关的过敏反应
Jiung Jeong1, Jeong-Eun Yun1, Hyun Jee Kim2
1Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
概括
神经肌肉阻断剂 (NMBAs) 可以引起过敏反应. 虽然皮肤检测有助于识别反应性NMBA,但负面结果并不能完全消除反复过敏症的风险,特别是与化学上类似的药物.
科学领域:
- 麻醉学 麻醉学
- 临床免疫学临床免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 神经肌肉阻断剂 (NMBA) 是外科手术期间过敏反应的常见原因.
- 皮肤测试可以识别导致过敏反应的NMBA,但其在负面结果下保证安全的能力尚不确定.
研究的目的:
- 评估使用皮肤测试选择的替代NMBAs在疑似NMBA诱导的过敏反应患者的真实世界的安全性.
主要方法:
- 在首尔国立大学医院 (2009年6月至2021年5月) 进行了一项回顾性队列研究,该研究对在首尔国立大学医院经历疑似NMBA诱导过敏症的患者进行了回顾性队列研究.
- 对患者特征,结果和皮肤测试结果的分析,包括交叉反应模式.
主要成果:
- 在282,707次NMBA管理中,47例 (0.017%) 的疑似过敏反应发生.
- 皮肤测试显示高阳性 (94.6%) 和交叉反应性 (75.7%),与NMBA之间的化学相似性有关.
- 15名患者接受了NMBA阴性皮肤测试;80%的人耐受了药物,但20%的人出现了低血压.
结论:
- 化学结构的相似性有助于皮肤测试中的NMBA交叉反应.
- 对NMBA过敏反应的阴性皮肤测试具有很高的负面可预测性,但不能完全排除复发反应.
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