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  • Title: Anaphylaxis during general anaesthesia: one-year survey from a British allergy clinic.
    Author: Chong YY, Caballero MR, Lukawska J, Dugué P.
    Journal: Singapore Med J; 2008 Jun; 49(6):483-7. PubMed ID: 18581023.
    Abstract:
    INTRODUCTION: Anaphylaxis during general anaesthesia is a major concern. Early recognition and management of anaphylaxis, as well as its future prevention, remain a challenge for the anaesthetists, while for the allergists, the elucidation of the causal agents may be difficult. We aimed to describe our experience in our drug allergy clinic. METHODS: We retrospectively reviewed 23 consecutive adult patients who presented with anaphylaxis during anaesthesia from March 1, 2005 to February 28, 2006. RESULTS: Out of the 23 patients (12 females, 11 males) with mean age (+/- SD) of 53.1 +/- 15.8 years, 15 patients were found to have a positive skin test to at least one neuromuscular blocking agent (NMBA); all of them showed cross-sensitivity with one or more NMBA(s). Three patients had a positive skin test to opioids, two patients to gelofusine, two patients to penicillin, and one patient each to povidone-iodine and chlorhexidine. Two patients had negative test results to agents used during their anaesthesia. Four patients had double positive skin tests to different families of drugs/agents. 18 patients had severe reaction-grade 3, and 15 of them tested positive for NMBA(s). Serum tryptase levels were known in nine patients. We did not encounter any latex or hypnotics sensitisation. CONCLUSION: NMBA was the commonest cause of anaphylaxis during general anaesthesia, occurring in 65% in our series.
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